Rational Management of Iron-Deficiency Anaemia in Inflammatory Bowel Disease
Abstract
:1. Introduction
1.1. Anaemia in Inflammatory Bowel Disease
1.2. Anaemia in Other Chronic Diseases
1.3. General Health Effects of Anaemia
2. Pathophysiology of Anaemia in IBD
2.1. Structure of Iron
2.2. Iron Homeostasis
2.3. Inflammatory Modulators in Anaemia
3. Diagnostic Investigations
3.1. Transferrin and Transferrin Saturation
3.2. Ferritin
3.3. Soluble Transferrin Receptor
3.4. Red Cell Indices
3.5. Bone Marrow Analyses
3.6. Hepcidin
4. Treatment of Anaemia
5. Iron Replacement Formulations
5.1. Oral Regimen
5.2. Intravenous Regimen
5.2.1. Low-Molecular-Weight Iron
5.2.2. High-Molecular-Weight Iron Compounds
6. Evidence of Management
7. Recommendations for Clinicians
7.1. Oral versus Intravenous Iron Supplementation
7.2. Surveillance of Patients Following Iron Supplementation
7.3. General Precautions for Iron Supplementation
8. Conclusions
Author Contributions
Conflicts of Interest
References
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Iron Administration | Pros | Cons |
---|---|---|
Oral | Low cost Convenient Available over the counter Efficient when intestinal absorption is not impaired | Mucosal injury Alteration of microbiota Various disorders may impair uptake, e.g., celiac disease, ACD *, autoimmune gastritis High intestinal iron concentrations due to low bioavailability cause gastrointestinal side effects (nausea, vomiting, abdominal pain and constipation) and limit compliance |
Intravenous | Fast repletion of iron stores Safe if formulations with dextran are avoided Effective even when intestinal absorption is impaired | Higher expenses, including need for administration by a healthcare professional Potential risk for iron overload that in excess may contribute to oxidative stress Potential risk for anaphylactic reactions using dextran-containing formulations Hypophosphatemia with some preparations |
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Nielsen, O.H.; Soendergaard, C.; Vikner, M.E.; Weiss, G. Rational Management of Iron-Deficiency Anaemia in Inflammatory Bowel Disease. Nutrients 2018, 10, 82. https://doi.org/10.3390/nu10010082
Nielsen OH, Soendergaard C, Vikner ME, Weiss G. Rational Management of Iron-Deficiency Anaemia in Inflammatory Bowel Disease. Nutrients. 2018; 10(1):82. https://doi.org/10.3390/nu10010082
Chicago/Turabian StyleNielsen, Ole Haagen, Christoffer Soendergaard, Malene Elbaek Vikner, and Günter Weiss. 2018. "Rational Management of Iron-Deficiency Anaemia in Inflammatory Bowel Disease" Nutrients 10, no. 1: 82. https://doi.org/10.3390/nu10010082
APA StyleNielsen, O. H., Soendergaard, C., Vikner, M. E., & Weiss, G. (2018). Rational Management of Iron-Deficiency Anaemia in Inflammatory Bowel Disease. Nutrients, 10(1), 82. https://doi.org/10.3390/nu10010082