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Multicenter Study
. 2024 Jan;103(1):1-4.
doi: 10.1007/s00277-023-05450-9. Epub 2023 Nov 9.

Small bowel lesions in patients with iron deficiency anaemia without overt bleeding: a multicentre study

Angelo Zullo  1 , Vincenzo De Francesco  2 , Luigi Gatta  3 , Giuseppe Scaccianoce  4 , Matteo Colombo  5 , Roberto Bringiotti  6 , Alessandro Azzarone  6 , Angela Rago  7 , Federico Corti  3 , Alessandro Repici  5   8 , Cesare Hassan  5   8 , Roberta Elisa Rossi  5
Affiliations
Multicenter Study

Small bowel lesions in patients with iron deficiency anaemia without overt bleeding: a multicentre study

Angelo Zullo et al. Ann Hematol. 2024 Jan.

Abstract

The diagnostic work-up in iron deficiency anaemia (IDA) patients can be challenging when bleedings or malabsorption are not clinically manifest. Lesions on the small bowel mucosa may cause IDA. We evaluated the prevalence of lesions on the small bowel mucosa detected at Videocapsule Endoscopy (VCE) in IDA patients following negative upper and lower endoscopies. Clinical and endoscopic data collected in 5 centres were retrieved. Lesions with a high bleeding potential (P2) were computed, and predictive factors investigated at multivariate analysis. By considering data of 230 patients, the endoscopic examination detected a total of 96 (41.7%; 95% CI: 35.4-48.1) P2 lesions on the small bowel mucosa, including 4 (1.7%) cancers. The use of non-steroidal anti-inflammatory drugs was found to be the only associated factor at both univariate (OR: 5.7, 95% CI: 2.4-13.4; P <0.001) and multivariate (OR: 2.8; 95% CI: 1.7-3.9, P <0.01) analyses. Present study showed that evaluation of small bowel mucosa with VCE allows to disclose a potential cause of IDA in near half patients. The cooperation between haematologists and gastroenterologists in the diagnostic work-up may be useful.

Keywords: Diagnostic work-up; Iron deficiency anaemia; Small bowel; Videocapsule endoscopy.

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