Do patients with iron deficiency without anemia benefit from an endoscopic examination?
OBJECTIVE The need for endoscopic investigation in patients with iron deficiency without anemia (ID) is not established. METHODS Data from patients with ID (serum ferritin ≤20 ng/mL, normal hemoglobin) studied with upper and lower endoscopies were retrospectively analyzed. Patients evaluated for iro...
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| Veröffentlicht in: | Journal of digestive diseases 2017-07, Vol.18 (7), p.416-424 |
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| creator | García García de Paredes, Ana Teruel Sánchez‐Vegazo, Carlos Hernanz Ruiz, Nerea Ferre Aracil, Carlos Rodríguez de Santiago, Enrique Aguilera Castro, Lara Sierra Morales, María Albillos, Agustín |
| description | OBJECTIVE
The need for endoscopic investigation in patients with iron deficiency without anemia (ID) is not established.
METHODS
Data from patients with ID (serum ferritin ≤20 ng/mL, normal hemoglobin) studied with upper and lower endoscopies were retrospectively analyzed. Patients evaluated for iron deficiency anemia (IDA) served as controls, matched by sex and age in the proportion of 2:1. The groups were compared for the presence, type, location and age distribution of endoscopic findings.
RESULTS
Altogether 109 patients (55% women; mean age 59.6 ± 13.5 years; aged |
| doi_str_mv | 10.1111/1751-2980.12495 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1909233971</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1909233971</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3715-4dd771e33056fd13e1718bc50a1d2143385bc459397eda210a80b3771f717b373</originalsourceid><addsrcrecordid>eNqFkL1PwzAQxS0EoqUwsyFLLCyhdhzHyYRQy5dUiQXEaDmOI1wlcYgTlf73XJrSgQUvvnv-3fPpIXRJyS2FM6eC0yBME2jDKOVHaHpQjg-1CCfozPs1ITwWSXyKJmESkyTmfIo-lg43qrOm7jze2O4T29bVODeF1SDq7U50fYdVbSqrcGZqeOtw0boKNGzq3HntGqux-VaVrcHM1Xfn6KRQpTcX-3uG3h8f3hbPwer16WVxvwo0E5QHUZ4LQQ1jsFqRU2aooEmmOVE0D2nEWMIzHfGUpcLkKqREJSRjMFIIKqBgM3Qz-jat--qN72RlvTZlCeu63kuakjRkME4Bvf6Drl3f1rAdUMNPCYlSoOYjpVvnfWsK2bS2Uu1WUiKHzOWQqhwSlrvMYeJq79tnlckP_G_IAPAR2NjSbP_zk4vlcjT-AbKIib0</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1933858049</pqid></control><display><type>article</type><title>Do patients with iron deficiency without anemia benefit from an endoscopic examination?</title><source>MEDLINE</source><source>Wiley Online Library All Journals</source><creator>García García de Paredes, Ana ; Teruel Sánchez‐Vegazo, Carlos ; Hernanz Ruiz, Nerea ; Ferre Aracil, Carlos ; Rodríguez de Santiago, Enrique ; Aguilera Castro, Lara ; Sierra Morales, María ; Albillos, Agustín</creator><creatorcontrib>García García de Paredes, Ana ; Teruel Sánchez‐Vegazo, Carlos ; Hernanz Ruiz, Nerea ; Ferre Aracil, Carlos ; Rodríguez de Santiago, Enrique ; Aguilera Castro, Lara ; Sierra Morales, María ; Albillos, Agustín</creatorcontrib><description>OBJECTIVE
The need for endoscopic investigation in patients with iron deficiency without anemia (ID) is not established.
METHODS
Data from patients with ID (serum ferritin ≤20 ng/mL, normal hemoglobin) studied with upper and lower endoscopies were retrospectively analyzed. Patients evaluated for iron deficiency anemia (IDA) served as controls, matched by sex and age in the proportion of 2:1. The groups were compared for the presence, type, location and age distribution of endoscopic findings.
RESULTS
Altogether 109 patients (55% women; mean age 59.6 ± 13.5 years; aged <50 years [27.5%]; 50–69 years [43.1%]; ≥70 years [29.4%]) were included in the ID group and 218 matched controls in the IDA group. Lesions were found in a similar proportion of patients (53.2% in the ID group vs 49.1% in the IDA group, P = 0.48) irrespective of age (P = 0.92). The colonoscopy diagnostic yield was low in both the ID and IDA subgroups of aged <50 years (6.3% vs 4.2%, P = 0.76). Multivariate analysis revealed a significant relationship between age (odds ratio [OR] 1.04, 95% confidence interval [CI] 1.02–1.06) and male sex (OR 2.28, 95% CI 1.18–4.39) with a positive colonoscopy. Malignancy was significantly less frequent in the ID group (1.8% vs 14.2%, P < 0.05).
CONCLUSIONS
The prevalence of gastrointestinal lesions in patients with and without anemia was similar but malignancy was eight times less frequent in the ID group. Systematic endoscopic evaluation in patients with ID is therefore questionable.</description><identifier>ISSN: 1751-2972</identifier><identifier>EISSN: 1751-2980</identifier><identifier>DOI: 10.1111/1751-2980.12495</identifier><identifier>PMID: 28608655</identifier><language>eng</language><publisher>Melbourne: Wiley Publishing Asia Pty Ltd</publisher><subject>Age ; Age composition ; Age Distribution ; Aged ; Anemia ; Anemia, Iron-Deficiency - etiology ; Colon ; Colonoscopy ; Endoscopy ; Endoscopy, Digestive System ; Female ; Ferritin ; Ferritins - blood ; Gastrointestinal Diseases - blood ; Gastrointestinal Diseases - complications ; Gastrointestinal Diseases - diagnosis ; Gastrointestinal Hemorrhage - complications ; Gastrointestinal Neoplasms - blood ; Gastrointestinal Neoplasms - complications ; Gastrointestinal Neoplasms - diagnosis ; Hemoglobin ; Humans ; Iron ; Iron - deficiency ; Male ; Malignancy ; Middle Aged ; Multivariate analysis ; Nutrient deficiency ; Retrospective Studies</subject><ispartof>Journal of digestive diseases, 2017-07, Vol.18 (7), p.416-424</ispartof><rights>2017 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd</rights><rights>2017 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3715-4dd771e33056fd13e1718bc50a1d2143385bc459397eda210a80b3771f717b373</citedby><cites>FETCH-LOGICAL-c3715-4dd771e33056fd13e1718bc50a1d2143385bc459397eda210a80b3771f717b373</cites><orcidid>0000-0001-5498-6280 ; 0000-0002-2852-6042</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2F1751-2980.12495$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2F1751-2980.12495$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27923,27924,45573,45574</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28608655$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>García García de Paredes, Ana</creatorcontrib><creatorcontrib>Teruel Sánchez‐Vegazo, Carlos</creatorcontrib><creatorcontrib>Hernanz Ruiz, Nerea</creatorcontrib><creatorcontrib>Ferre Aracil, Carlos</creatorcontrib><creatorcontrib>Rodríguez de Santiago, Enrique</creatorcontrib><creatorcontrib>Aguilera Castro, Lara</creatorcontrib><creatorcontrib>Sierra Morales, María</creatorcontrib><creatorcontrib>Albillos, Agustín</creatorcontrib><title>Do patients with iron deficiency without anemia benefit from an endoscopic examination?</title><title>Journal of digestive diseases</title><addtitle>J Dig Dis</addtitle><description>OBJECTIVE
The need for endoscopic investigation in patients with iron deficiency without anemia (ID) is not established.
METHODS
Data from patients with ID (serum ferritin ≤20 ng/mL, normal hemoglobin) studied with upper and lower endoscopies were retrospectively analyzed. Patients evaluated for iron deficiency anemia (IDA) served as controls, matched by sex and age in the proportion of 2:1. The groups were compared for the presence, type, location and age distribution of endoscopic findings.
RESULTS
Altogether 109 patients (55% women; mean age 59.6 ± 13.5 years; aged <50 years [27.5%]; 50–69 years [43.1%]; ≥70 years [29.4%]) were included in the ID group and 218 matched controls in the IDA group. Lesions were found in a similar proportion of patients (53.2% in the ID group vs 49.1% in the IDA group, P = 0.48) irrespective of age (P = 0.92). The colonoscopy diagnostic yield was low in both the ID and IDA subgroups of aged <50 years (6.3% vs 4.2%, P = 0.76). Multivariate analysis revealed a significant relationship between age (odds ratio [OR] 1.04, 95% confidence interval [CI] 1.02–1.06) and male sex (OR 2.28, 95% CI 1.18–4.39) with a positive colonoscopy. Malignancy was significantly less frequent in the ID group (1.8% vs 14.2%, P < 0.05).
CONCLUSIONS
The prevalence of gastrointestinal lesions in patients with and without anemia was similar but malignancy was eight times less frequent in the ID group. Systematic endoscopic evaluation in patients with ID is therefore questionable.</description><subject>Age</subject><subject>Age composition</subject><subject>Age Distribution</subject><subject>Aged</subject><subject>Anemia</subject><subject>Anemia, Iron-Deficiency - etiology</subject><subject>Colon</subject><subject>Colonoscopy</subject><subject>Endoscopy</subject><subject>Endoscopy, Digestive System</subject><subject>Female</subject><subject>Ferritin</subject><subject>Ferritins - blood</subject><subject>Gastrointestinal Diseases - blood</subject><subject>Gastrointestinal Diseases - complications</subject><subject>Gastrointestinal Diseases - diagnosis</subject><subject>Gastrointestinal Hemorrhage - complications</subject><subject>Gastrointestinal Neoplasms - blood</subject><subject>Gastrointestinal Neoplasms - complications</subject><subject>Gastrointestinal Neoplasms - diagnosis</subject><subject>Hemoglobin</subject><subject>Humans</subject><subject>Iron</subject><subject>Iron - deficiency</subject><subject>Male</subject><subject>Malignancy</subject><subject>Middle Aged</subject><subject>Multivariate analysis</subject><subject>Nutrient deficiency</subject><subject>Retrospective Studies</subject><issn>1751-2972</issn><issn>1751-2980</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkL1PwzAQxS0EoqUwsyFLLCyhdhzHyYRQy5dUiQXEaDmOI1wlcYgTlf73XJrSgQUvvnv-3fPpIXRJyS2FM6eC0yBME2jDKOVHaHpQjg-1CCfozPs1ITwWSXyKJmESkyTmfIo-lg43qrOm7jze2O4T29bVODeF1SDq7U50fYdVbSqrcGZqeOtw0boKNGzq3HntGqux-VaVrcHM1Xfn6KRQpTcX-3uG3h8f3hbPwer16WVxvwo0E5QHUZ4LQQ1jsFqRU2aooEmmOVE0D2nEWMIzHfGUpcLkKqREJSRjMFIIKqBgM3Qz-jat--qN72RlvTZlCeu63kuakjRkME4Bvf6Drl3f1rAdUMNPCYlSoOYjpVvnfWsK2bS2Uu1WUiKHzOWQqhwSlrvMYeJq79tnlckP_G_IAPAR2NjSbP_zk4vlcjT-AbKIib0</recordid><startdate>201707</startdate><enddate>201707</enddate><creator>García García de Paredes, Ana</creator><creator>Teruel Sánchez‐Vegazo, Carlos</creator><creator>Hernanz Ruiz, Nerea</creator><creator>Ferre Aracil, Carlos</creator><creator>Rodríguez de Santiago, Enrique</creator><creator>Aguilera Castro, Lara</creator><creator>Sierra Morales, María</creator><creator>Albillos, Agustín</creator><general>Wiley Publishing Asia Pty Ltd</general><general>Wiley Subscription Services, Inc</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>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5498-6280</orcidid><orcidid>https://orcid.org/0000-0002-2852-6042</orcidid></search><sort><creationdate>201707</creationdate><title>Do patients with iron deficiency without anemia benefit from an endoscopic examination?</title><author>García García de Paredes, Ana ; Teruel Sánchez‐Vegazo, Carlos ; Hernanz Ruiz, Nerea ; Ferre Aracil, Carlos ; Rodríguez de Santiago, Enrique ; Aguilera Castro, Lara ; Sierra Morales, María ; Albillos, Agustín</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3715-4dd771e33056fd13e1718bc50a1d2143385bc459397eda210a80b3771f717b373</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Age</topic><topic>Age composition</topic><topic>Age Distribution</topic><topic>Aged</topic><topic>Anemia</topic><topic>Anemia, Iron-Deficiency - etiology</topic><topic>Colon</topic><topic>Colonoscopy</topic><topic>Endoscopy</topic><topic>Endoscopy, Digestive System</topic><topic>Female</topic><topic>Ferritin</topic><topic>Ferritins - blood</topic><topic>Gastrointestinal Diseases - blood</topic><topic>Gastrointestinal Diseases - complications</topic><topic>Gastrointestinal Diseases - diagnosis</topic><topic>Gastrointestinal Hemorrhage - complications</topic><topic>Gastrointestinal Neoplasms - blood</topic><topic>Gastrointestinal Neoplasms - complications</topic><topic>Gastrointestinal Neoplasms - diagnosis</topic><topic>Hemoglobin</topic><topic>Humans</topic><topic>Iron</topic><topic>Iron - deficiency</topic><topic>Male</topic><topic>Malignancy</topic><topic>Middle Aged</topic><topic>Multivariate analysis</topic><topic>Nutrient deficiency</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>García García de Paredes, Ana</creatorcontrib><creatorcontrib>Teruel Sánchez‐Vegazo, Carlos</creatorcontrib><creatorcontrib>Hernanz Ruiz, Nerea</creatorcontrib><creatorcontrib>Ferre Aracil, Carlos</creatorcontrib><creatorcontrib>Rodríguez de Santiago, Enrique</creatorcontrib><creatorcontrib>Aguilera Castro, Lara</creatorcontrib><creatorcontrib>Sierra Morales, María</creatorcontrib><creatorcontrib>Albillos, Agustín</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of digestive diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>García García de Paredes, Ana</au><au>Teruel Sánchez‐Vegazo, Carlos</au><au>Hernanz Ruiz, Nerea</au><au>Ferre Aracil, Carlos</au><au>Rodríguez de Santiago, Enrique</au><au>Aguilera Castro, Lara</au><au>Sierra Morales, María</au><au>Albillos, Agustín</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Do patients with iron deficiency without anemia benefit from an endoscopic examination?</atitle><jtitle>Journal of digestive diseases</jtitle><addtitle>J Dig Dis</addtitle><date>2017-07</date><risdate>2017</risdate><volume>18</volume><issue>7</issue><spage>416</spage><epage>424</epage><pages>416-424</pages><issn>1751-2972</issn><eissn>1751-2980</eissn><abstract>OBJECTIVE
The need for endoscopic investigation in patients with iron deficiency without anemia (ID) is not established.
METHODS
Data from patients with ID (serum ferritin ≤20 ng/mL, normal hemoglobin) studied with upper and lower endoscopies were retrospectively analyzed. Patients evaluated for iron deficiency anemia (IDA) served as controls, matched by sex and age in the proportion of 2:1. The groups were compared for the presence, type, location and age distribution of endoscopic findings.
RESULTS
Altogether 109 patients (55% women; mean age 59.6 ± 13.5 years; aged <50 years [27.5%]; 50–69 years [43.1%]; ≥70 years [29.4%]) were included in the ID group and 218 matched controls in the IDA group. Lesions were found in a similar proportion of patients (53.2% in the ID group vs 49.1% in the IDA group, P = 0.48) irrespective of age (P = 0.92). The colonoscopy diagnostic yield was low in both the ID and IDA subgroups of aged <50 years (6.3% vs 4.2%, P = 0.76). Multivariate analysis revealed a significant relationship between age (odds ratio [OR] 1.04, 95% confidence interval [CI] 1.02–1.06) and male sex (OR 2.28, 95% CI 1.18–4.39) with a positive colonoscopy. Malignancy was significantly less frequent in the ID group (1.8% vs 14.2%, P < 0.05).
CONCLUSIONS
The prevalence of gastrointestinal lesions in patients with and without anemia was similar but malignancy was eight times less frequent in the ID group. Systematic endoscopic evaluation in patients with ID is therefore questionable.</abstract><cop>Melbourne</cop><pub>Wiley Publishing Asia Pty Ltd</pub><pmid>28608655</pmid><doi>10.1111/1751-2980.12495</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-5498-6280</orcidid><orcidid>https://orcid.org/0000-0002-2852-6042</orcidid></addata></record> |
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| subjects | Age Age composition Age Distribution Aged Anemia Anemia, Iron-Deficiency - etiology Colon Colonoscopy Endoscopy Endoscopy, Digestive System Female Ferritin Ferritins - blood Gastrointestinal Diseases - blood Gastrointestinal Diseases - complications Gastrointestinal Diseases - diagnosis Gastrointestinal Hemorrhage - complications Gastrointestinal Neoplasms - blood Gastrointestinal Neoplasms - complications Gastrointestinal Neoplasms - diagnosis Hemoglobin Humans Iron Iron - deficiency Male Malignancy Middle Aged Multivariate analysis Nutrient deficiency Retrospective Studies |
| title | Do patients with iron deficiency without anemia benefit from an endoscopic examination? |
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