Iron Deficiency Anemia in the Elderly: Prevalence and Endoscopic Evaluation of the Gastrointestinal Tract in Outpatients

2003 ◽  
Vol 110 (1) ◽  
pp. 25-28 ◽  
Author(s):  
Erkan Çoban ◽  
Ayşen Timuragaoglu ◽  
Mehmet Meriç
Keyword(s):  
Gastrointestinal Tract ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
The Elderly ◽  
Deficiency Anemia ◽  
Endoscopic Evaluation

OCCULT BLOOD LOSS IN IRON DEFICIENCY ANEMIA OF INFANCY

PEDIATRICS ◽  
1961 ◽  
Vol 27 (2) ◽  
pp. 199-203
Author(s):  
M. Silvija Hoag ◽  
Ralph O. Wallerstein ◽  
Myron Pollycove
Keyword(s):  
Early Childhood ◽  
Gastrointestinal Tract ◽  
Iron Deficiency ◽  
Blood Loss ◽  
Iron Deficiency Anemia ◽  
Whole Blood ◽  
Occult Blood ◽  
Deficiency Anemia ◽  
Observation Period

Blood loss from the gastrointestinal tract was measured in 13 infants with iron deficiency anemia, using radioiron as a tracer. The radioiron was given intravenously; radioactivity in the erythrocytes and feces was measured for the following 3 to 4 weeks. The percentage of total Fe administered that was recovered in the stools varied between 0.75 and 16.4%, with a mean of 5.75%. This represents loss of whole blood in the stools varying from 7 to 107 ml, with a mean of 41 ml during the observation period. Occult blood loss from the gastrointestinal tract appears to be a significant factor in the development of iron deficiency in early childhood.

scholarly journals Upper Gastrointestinal Crohn’s Disease: Literature Review and Case Presentation

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Soorya N. Aggarwal ◽  
Yana Cavanagh ◽  
Lan Wang ◽  
Amer Akmal ◽  
Matthew A. Grossman
Keyword(s):  
Crohn’S Disease ◽  
Gastrointestinal Tract ◽  
Iron Deficiency ◽  
Crohn's Disease ◽  
Fecal Calprotectin ◽  
Upper Gastrointestinal Tract ◽  
Laboratory Evaluation ◽  
Deficiency Anemia ◽  
Endoscopic Evaluation ◽  
Upper Gastrointestinal

Upper gastrointestinal tract predominant Crohn’s Disease (CD) remains an elusive clinical entity, manifesting limited or vague symptomatology, eluding clinical suspicion, and delaying subsequent diagnostic evaluation. As a result, it has not been widely described and there is a lack of clear recommendations for diagnosis or management. Standard IBD evaluation including serologic testing, imaging, and endoscopy may initially not be fruitful. Furthermore, endoscopic evaluation may be grossly normal in patients without long standing-disease. We describe an 18-year-old male who presented with only unexplained, persistent iron-deficiency anemia. Extensive outpatient testing including multiple endoscopic evaluations with standard biopsies was unfruitful. Ultimately, a positive fecal calprotectin prompted enteroscopy with endoscopic mucosal resection (EMR) in an effort to obtain a larger, deeper tissue specimen. Grossly cobblestoned mucosa along with histopathology revealing focal crypt abscesses, chronic inflammation in the lamina propria, and superficial foveolar epithelial regenerative changes were consistent with CD. This patient’s case illustrates the need for a high degree of suspicion for CD in patients with unexplained or persistent iron deficiency anemias. Persistent investigation yielded an elevation in fecal calprotectin suggesting underlying gastrointestinal inflammation and prompted advanced endoscopic evaluation with EMR. Waxing and waning tissue findings are characteristic of CD and pose a unique challenge in patients with upper gastrointestinal predominant pathology. As such, diligent workup including laboratory evaluation, imaging, and serial endoscopy is critical to establish pathology and dictate subsequent management in IBD, especially upper gastrointestinal tract predominant CD.

scholarly journals Molecular Aspects and Treatment of Iron Deficiency in the Elderly

2020 ◽  
Vol 21 (11) ◽  
pp. 3821
Author(s):  
Antonino Davide Romano ◽  
Annalisa Paglia ◽  
Francesco Bellanti ◽  
Rosanna Villani ◽  
Moris Sangineto ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Iron Homeostasis ◽  
Diagnostic Algorithm ◽  
The Elderly ◽  
Deficiency Anemia ◽  
Clinical State ◽  
Ageing Population ◽  
Gastrointestinal Lesions ◽  
Aged Subjects

Iron deficiency (ID) is the most frequent nutritional deficiency in the whole population worldwide, and the second most common cause of anemia in the elderly. The prevalence of anemia is expecting to rise shortly, because of an ageing population. Even though WHO criteria define anemia as a hemoglobin serum concentration <12 g/dL in women and <13 g/dL in men, several authors propose different and specific cut-off values for the elderly. Anemia in aged subjects impacts health and quality of life, and it is associated with several negative outcomes, such as longer time of hospitalization and a higher risk of disability. Furthermore, it is an independent risk factor of increased morbidity and mortality. Even though iron deficiency anemia is a common disorder in older adults, it should be not considered as a normal ageing consequence, but a sign of underlying dysfunction. Relating to the molecular mechanism in Iron Deficiency Anemia (IDA), hepcidin has a key role in iron homeostasis. It downregulates the iron exporter ferroportin, inhibiting both iron absorption and release. IDA is frequently dependent on blood loss, especially caused by gastrointestinal lesions. Thus, a diagnostic algorithm for IDA should include invasive investigation such as endoscopic procedures. The treatment choice is influenced by the severity of anemia, underlying conditions, comorbidities, and the clinical state of the patient. Correction of anemia and iron supplementation should be associated with the treatment of the causal disease.

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