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. 2008 Nov 9:8:52.
doi: 10.1186/1471-230X-8-52.

Predictors of gastrointestinal lesions on endoscopy in iron deficiency anemia without gastrointestinal symptoms

Shahid Majid  1 , Mohammad Salih, Rozina Wasaya, Wasim Jafri
Affiliations

Predictors of gastrointestinal lesions on endoscopy in iron deficiency anemia without gastrointestinal symptoms

Shahid Majid et al. BMC Gastroenterol. .

Abstract

Background: Iron deficiency anaemia (IDA) due to occult gastrointestinal (GI) blood loss usually remains unnoticed until patient become symptomatic. There is sparse data in IDA patients without gastrointestinal symptoms. This study was designed to find out the frequency and predictors of endoscopic lesions in IDA without gastrointestinal symptoms. Cross-sectional study performed on a convenience sample of consecutive subjects.

Methods: Ninety five consecutive patients with laboratory based diagnosis of IDA having no gastrointestinal symptoms were interviewed and their clinical and biochemical variables were recorded. All the study patients underwent esophago-gastroduodenoscopy (EGD) and colonoscopy. Endoscopic findings were documented as presence/absence of bleeding related lesion and presence/absence of cause of IDA. Multiple logistic regressions were performed to identify variables significantly related to outcome variables.

Results: Possible cause of anaemia was found in 71% and bleeding related lesions were found in 53% of patients. Upper gastrointestinal tract lesions were found in 41% of patients with bleeding related lesions. On multivariable logistic regression; advancing age, low mean corpuscular volume (MCV<or=60 fl), and positive fecal occult blood test were predictive factors for bleeding related GI lesions and cause of IDA CONCLUSION: Clinical and Biochemical markers can predict gastrointestinal lesions on endoscopy in IDA patients without gastrointestinal symptoms. High proportion of upper gastrointestinal involvement warrants EGD as initial endoscopic procedure however, this needs validation by further studies.

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Figures

Figure 1
Figure 1
Site of Involvement of gastrointestinal tract (Percentage).
Figure 2
Figure 2
Graph showing ROC curve for bleeding related lesion.
Figure 3
Figure 3
Graph showing ROC curve for cause of iron deficiency anaemia.
See this image and copyright information in PMC

References

    1. Jolobe O. Guidelines for the management of iron deficiency anaemia. Gut. 2001;49:158–164. doi: 10.1136/gut.49.1.158. - DOI - PMC - PubMed
    1. Lindsay JO, Robinson SD, Jackson JE, Walters JR. The investigation of iron deficiency anemia – a hospital based audit. Hepatogastroenterology. 1999;46:2887–90. - PubMed
    1. Zuckerman GR, Prakash C, Askin MP, Lewis BS. American Gastroenterological Association medical position statement: evaluation and management of occult and obscure gastrointestinal bleeding. Gastroenterology. 2000;118:197–201. doi: 10.1016/S0016-5085(00)70430-6. - DOI - PubMed
    1. Zukerman G, Benitez J. A prospective study of bidirectional endoscopy (colonoscopy and upper endoscopy) in the evaluation of patients with occult gastrointestinal bleeding. Am J Gastroenterol. 1994;87:62–66. - PubMed
    1. Gordon SR, Smith RE, Power GC. The role of endoscopy in the evaluation of iron deficiency anemia in patients over the age of 50. Am J Gastroenterol. 1994;89:1963–1967. - PubMed