Iron Deficiency in Inflammatory Bowel Disease: The use of Zincprotoporphyrin and Red Blood Cell Distribution Width
OBJECTIVES:Iron deficiency (ID) in children with inflammatory bowel disease (IBD) is either an absolute (depleted iron stores) or a functional deficiency (caused by chronic inflammation). Differentiating between these two types of ID is important because they require a different therapeutic approach...
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| Veröffentlicht in: | Journal of pediatric gastroenterology and nutrition 2017-06, Vol.64 (6), p.949-954 |
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| container_title | Journal of pediatric gastroenterology and nutrition |
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| creator | Akkermans, Marjolijn D Vreugdenhil, Mirjam Hendriks, Daniëlle M van den Berg, Anemone Schweizer, Joachim J van Goudoever, Johannes B Brus, Frank |
| description | OBJECTIVES:Iron deficiency (ID) in children with inflammatory bowel disease (IBD) is either an absolute (depleted iron stores) or a functional deficiency (caused by chronic inflammation). Differentiating between these two types of ID is important because they require a different therapeutic approach. Zinc protoporphyrin (ZPP) and red blood cell distribution width (RDW) are parameters of functional ID. Studies using these parameters to differentiate are non-existent. We aimed to evaluate the prevalence of and risk factors for absolute and functional ID in paediatric IBD patients while using ZPP and RDW.
METHODS:We evaluated the iron status and medical charts of 59 paediatric IBD patients in a secondary hospital in the Netherlands. Absolute ID was defined as serum ferritin 14%. Anaemia of chronic disease (ACD) was defined as functional ID in combination with anaemia.
RESULTS:Absolute and functional ID were found in 19/59 (32.2%) and 32/40 (80%) patients, respectively. The prevalence of IDA and ACD was 27.1% (16/59) and 20% (8/40), respectively. Multivariate analyses showed that absolute ID and IDA were both associated with a more recent IBD-diagnosis (both p-value |
| doi_str_mv | 10.1097/MPG.0000000000001406 |
| format | Article |
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METHODS:We evaluated the iron status and medical charts of 59 paediatric IBD patients in a secondary hospital in the Netherlands. Absolute ID was defined as serum ferritin <15 μg/l in the absence of infection and/or acute inflammation (C-reactive protein <10 mg/l). Iron deficiency anaemia (IDA) was defined as absolute ID in combination with anaemia. Functional ID, in patients without absolute ID, was defined as ZPP >70 μmol/mol haem and/or a RDW >14%. Anaemia of chronic disease (ACD) was defined as functional ID in combination with anaemia.
RESULTS:Absolute and functional ID were found in 19/59 (32.2%) and 32/40 (80%) patients, respectively. The prevalence of IDA and ACD was 27.1% (16/59) and 20% (8/40), respectively. Multivariate analyses showed that absolute ID and IDA were both associated with a more recent IBD-diagnosis (both p-value <0.05).
CONCLUSIONS:Absolute and functional ID are very common in paediatric IBD patients, and this differentiation is important because of therapeutic consequences. Furthermore, absolute ID and IDA are associated with a more recent IBD-diagnosis.</description><identifier>ISSN: 0277-2116</identifier><identifier>EISSN: 1536-4801</identifier><identifier>DOI: 10.1097/MPG.0000000000001406</identifier><identifier>PMID: 27622900</identifier><language>eng</language><publisher>United States: by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology</publisher><subject>Adolescent ; Anemia, Iron-Deficiency - blood ; Anemia, Iron-Deficiency - diagnosis ; Anemia, Iron-Deficiency - epidemiology ; Anemia, Iron-Deficiency - etiology ; Biomarkers - blood ; Child ; Cross-Sectional Studies ; Diagnosis, Differential ; Erythrocyte Indices ; Female ; Humans ; Inflammatory Bowel Diseases - blood ; Inflammatory Bowel Diseases - complications ; Inflammatory Bowel Diseases - physiopathology ; Male ; Multivariate Analysis ; Prevalence ; Protoporphyrins - blood ; Risk Factors</subject><ispartof>Journal of pediatric gastroenterology and nutrition, 2017-06, Vol.64 (6), p.949-954</ispartof><rights>2016 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3056-e11bef9cdfcd0c84f2c4c85b84fe023ad0542c6801305a194e40420e535bff373</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27622900$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Akkermans, Marjolijn D</creatorcontrib><creatorcontrib>Vreugdenhil, Mirjam</creatorcontrib><creatorcontrib>Hendriks, Daniëlle M</creatorcontrib><creatorcontrib>van den Berg, Anemone</creatorcontrib><creatorcontrib>Schweizer, Joachim J</creatorcontrib><creatorcontrib>van Goudoever, Johannes B</creatorcontrib><creatorcontrib>Brus, Frank</creatorcontrib><title>Iron Deficiency in Inflammatory Bowel Disease: The use of Zincprotoporphyrin and Red Blood Cell Distribution Width</title><title>Journal of pediatric gastroenterology and nutrition</title><addtitle>J Pediatr Gastroenterol Nutr</addtitle><description>OBJECTIVES:Iron deficiency (ID) in children with inflammatory bowel disease (IBD) is either an absolute (depleted iron stores) or a functional deficiency (caused by chronic inflammation). Differentiating between these two types of ID is important because they require a different therapeutic approach. Zinc protoporphyrin (ZPP) and red blood cell distribution width (RDW) are parameters of functional ID. Studies using these parameters to differentiate are non-existent. We aimed to evaluate the prevalence of and risk factors for absolute and functional ID in paediatric IBD patients while using ZPP and RDW.
METHODS:We evaluated the iron status and medical charts of 59 paediatric IBD patients in a secondary hospital in the Netherlands. Absolute ID was defined as serum ferritin <15 μg/l in the absence of infection and/or acute inflammation (C-reactive protein <10 mg/l). Iron deficiency anaemia (IDA) was defined as absolute ID in combination with anaemia. Functional ID, in patients without absolute ID, was defined as ZPP >70 μmol/mol haem and/or a RDW >14%. Anaemia of chronic disease (ACD) was defined as functional ID in combination with anaemia.
RESULTS:Absolute and functional ID were found in 19/59 (32.2%) and 32/40 (80%) patients, respectively. The prevalence of IDA and ACD was 27.1% (16/59) and 20% (8/40), respectively. Multivariate analyses showed that absolute ID and IDA were both associated with a more recent IBD-diagnosis (both p-value <0.05).
CONCLUSIONS:Absolute and functional ID are very common in paediatric IBD patients, and this differentiation is important because of therapeutic consequences. Furthermore, absolute ID and IDA are associated with a more recent IBD-diagnosis.</description><subject>Adolescent</subject><subject>Anemia, Iron-Deficiency - blood</subject><subject>Anemia, Iron-Deficiency - diagnosis</subject><subject>Anemia, Iron-Deficiency - epidemiology</subject><subject>Anemia, Iron-Deficiency - etiology</subject><subject>Biomarkers - blood</subject><subject>Child</subject><subject>Cross-Sectional Studies</subject><subject>Diagnosis, Differential</subject><subject>Erythrocyte Indices</subject><subject>Female</subject><subject>Humans</subject><subject>Inflammatory Bowel Diseases - blood</subject><subject>Inflammatory Bowel Diseases - complications</subject><subject>Inflammatory Bowel Diseases - physiopathology</subject><subject>Male</subject><subject>Multivariate Analysis</subject><subject>Prevalence</subject><subject>Protoporphyrins - blood</subject><subject>Risk Factors</subject><issn>0277-2116</issn><issn>1536-4801</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMtOwzAQRS0EoqXwBwh5ySbFdpwXO2ihVAKBUBESm8hxxoohiYudqOrfY2hBiAUzi5nFufO4CB1TMqYkS87uHmZj8isoJ_EOGtIojAOeErqLhoQlScAojQfowLlXDyU8IvtowJKYsYyQIbJza1o8BaWlhlausW7xvFW1aBrRGbvGl2YFNZ5qB8LBOV5UgHsH2Cj8olu5tKYzS2OX1dp6pWhL_AglvqyNKfEE6i9lZ3XRd9rvedZlVx2iPSVqB0fbOkJP11eLyU1wez-bTy5uAxmSKA6A0gJUJkslSyJTrpjkMo0K3wFhoShJxJmM_aceFzTjwAlnBKIwKpQKk3CETjdz_ZHvPbgub7ST_ibRguldTtMoS6jP2KN8g0prnLOg8qXVjbDrnJL80-3cu53_ddvLTrYb-qKB8kf0ba8H0g2wMnUH1r3V_QpsXoGou-r_2R9BrIvo</recordid><startdate>20170601</startdate><enddate>20170601</enddate><creator>Akkermans, Marjolijn D</creator><creator>Vreugdenhil, Mirjam</creator><creator>Hendriks, Daniëlle M</creator><creator>van den Berg, Anemone</creator><creator>Schweizer, Joachim J</creator><creator>van Goudoever, Johannes B</creator><creator>Brus, Frank</creator><general>by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20170601</creationdate><title>Iron Deficiency in Inflammatory Bowel Disease: The use of Zincprotoporphyrin and Red Blood Cell Distribution Width</title><author>Akkermans, Marjolijn D ; Vreugdenhil, Mirjam ; Hendriks, Daniëlle M ; van den Berg, Anemone ; Schweizer, Joachim J ; van Goudoever, Johannes B ; Brus, Frank</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3056-e11bef9cdfcd0c84f2c4c85b84fe023ad0542c6801305a194e40420e535bff373</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adolescent</topic><topic>Anemia, Iron-Deficiency - blood</topic><topic>Anemia, Iron-Deficiency - diagnosis</topic><topic>Anemia, Iron-Deficiency - epidemiology</topic><topic>Anemia, Iron-Deficiency - etiology</topic><topic>Biomarkers - blood</topic><topic>Child</topic><topic>Cross-Sectional Studies</topic><topic>Diagnosis, Differential</topic><topic>Erythrocyte Indices</topic><topic>Female</topic><topic>Humans</topic><topic>Inflammatory Bowel Diseases - blood</topic><topic>Inflammatory Bowel Diseases - complications</topic><topic>Inflammatory Bowel Diseases - physiopathology</topic><topic>Male</topic><topic>Multivariate Analysis</topic><topic>Prevalence</topic><topic>Protoporphyrins - blood</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Akkermans, Marjolijn D</creatorcontrib><creatorcontrib>Vreugdenhil, Mirjam</creatorcontrib><creatorcontrib>Hendriks, Daniëlle M</creatorcontrib><creatorcontrib>van den Berg, Anemone</creatorcontrib><creatorcontrib>Schweizer, Joachim J</creatorcontrib><creatorcontrib>van Goudoever, Johannes B</creatorcontrib><creatorcontrib>Brus, Frank</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of pediatric gastroenterology and nutrition</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Akkermans, Marjolijn D</au><au>Vreugdenhil, Mirjam</au><au>Hendriks, Daniëlle M</au><au>van den Berg, Anemone</au><au>Schweizer, Joachim J</au><au>van Goudoever, Johannes B</au><au>Brus, Frank</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Iron Deficiency in Inflammatory Bowel Disease: The use of Zincprotoporphyrin and Red Blood Cell Distribution Width</atitle><jtitle>Journal of pediatric gastroenterology and nutrition</jtitle><addtitle>J Pediatr Gastroenterol Nutr</addtitle><date>2017-06-01</date><risdate>2017</risdate><volume>64</volume><issue>6</issue><spage>949</spage><epage>954</epage><pages>949-954</pages><issn>0277-2116</issn><eissn>1536-4801</eissn><abstract>OBJECTIVES:Iron deficiency (ID) in children with inflammatory bowel disease (IBD) is either an absolute (depleted iron stores) or a functional deficiency (caused by chronic inflammation). Differentiating between these two types of ID is important because they require a different therapeutic approach. Zinc protoporphyrin (ZPP) and red blood cell distribution width (RDW) are parameters of functional ID. Studies using these parameters to differentiate are non-existent. We aimed to evaluate the prevalence of and risk factors for absolute and functional ID in paediatric IBD patients while using ZPP and RDW.
METHODS:We evaluated the iron status and medical charts of 59 paediatric IBD patients in a secondary hospital in the Netherlands. Absolute ID was defined as serum ferritin <15 μg/l in the absence of infection and/or acute inflammation (C-reactive protein <10 mg/l). Iron deficiency anaemia (IDA) was defined as absolute ID in combination with anaemia. Functional ID, in patients without absolute ID, was defined as ZPP >70 μmol/mol haem and/or a RDW >14%. Anaemia of chronic disease (ACD) was defined as functional ID in combination with anaemia.
RESULTS:Absolute and functional ID were found in 19/59 (32.2%) and 32/40 (80%) patients, respectively. The prevalence of IDA and ACD was 27.1% (16/59) and 20% (8/40), respectively. Multivariate analyses showed that absolute ID and IDA were both associated with a more recent IBD-diagnosis (both p-value <0.05).
CONCLUSIONS:Absolute and functional ID are very common in paediatric IBD patients, and this differentiation is important because of therapeutic consequences. Furthermore, absolute ID and IDA are associated with a more recent IBD-diagnosis.</abstract><cop>United States</cop><pub>by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology</pub><pmid>27622900</pmid><doi>10.1097/MPG.0000000000001406</doi><tpages>6</tpages></addata></record> |
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| ispartof | Journal of pediatric gastroenterology and nutrition, 2017-06, Vol.64 (6), p.949-954 |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; Journals@Ovid Complete |
| subjects | Adolescent Anemia, Iron-Deficiency - blood Anemia, Iron-Deficiency - diagnosis Anemia, Iron-Deficiency - epidemiology Anemia, Iron-Deficiency - etiology Biomarkers - blood Child Cross-Sectional Studies Diagnosis, Differential Erythrocyte Indices Female Humans Inflammatory Bowel Diseases - blood Inflammatory Bowel Diseases - complications Inflammatory Bowel Diseases - physiopathology Male Multivariate Analysis Prevalence Protoporphyrins - blood Risk Factors |
| title | Iron Deficiency in Inflammatory Bowel Disease: The use of Zincprotoporphyrin and Red Blood Cell Distribution Width |
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