Endoscopic evaluation of significant gastrointestinal lesions in patients with iron deficiency with and without anaemia

A Korean Association for the Study of Intestinal Disease Study

J. S. Park, D. I. Park, S. K. Park, J. S. Choi, Y. H. Kim, D. K. Chang, H. J. Son, J. E. Kim, J. O. Kim, S. H. Lee, H. S. Kim, J. E. Sin, S. G. Lee, S. Y. Lee, S. J. Park, C. H. Park, I. H. Baek, B. I. Jang, Yoon Tae Jeen, K. C. Huh

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Although endoscopy is recommended for patients with iron deficiency anaemia, there is, currently, no consensus on the role of endoscopy for iron-deficient patients without anaemia. The goal of this study was to determine the prevalence of serious gastrointestinal (GI) lesions, identified by endoscopy in patients with iron deficiency and anaemia compared with patients with iron deficiency without anaemia. Methods: One thousand five hundred and eighteen patients with a ferritin value of ≤50 ng/mL and a total iron-binding capacity ≥300 mg/dL were retrospectively investigated using oesophagogastroduodenoscopy and colonoscopy between January 2005 and September 2006. The lesions identified were classified as clinically important according to standard predetermined criteria. Results: Among the 1518 cases, 749 patients had anaemia and 769 had normal haemoglobin levels. Clinically important lesions were identified in 24.6% of the patients with anaemia and in 22.8% of the patients without anaemia (P > 0.05). The frequency of lower GI tract lesions (13.6 vs 11.4%, P > 0.05) and upper GI tract lesions (11.9 vs 12.5%, P > 0.05) was similar in the comparisons between the two groups. However, the frequency of malignant GI lesions was higher in the patients with anaemia (5.1 vs 0.7%, P < 0.01). In addition, the patients without anaemia were significantly more likely to have early-stage neoplasia (adenoma, early gastric cancer and Dukes' A and B colon cancer) than were the patients with anaemia (98.4 vs 52.5%, P < 0.01). Conclusion: The results of this study suggest that patients with iron deficiency should undergo endoscopic evaluation of the GI tract, irrespective of whether they have anaemia. The endoscopic evaluation of the GI tract in patients with iron deficiency without anaemia could provide an opportunity for the detection of early-stage neoplasia at a curable stage.

Original languageEnglish
Pages (from-to)441-446
Number of pages6
JournalInternal Medicine Journal
Volume39
Issue number7
DOIs
Publication statusPublished - 2009 Jul 1

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Intestinal Diseases
Anemia
Iron
Iron-Deficiency Anemias
Endoscopy
Gastrointestinal Tract
Lower Gastrointestinal Tract
Digestive System Endoscopy
Upper Gastrointestinal Tract
Colonoscopy
Ferritins
Adenoma
Colonic Neoplasms
Stomach Neoplasms
Neoplasms

Keywords

  • Anaemia
  • Colonoscopy
  • Iron deficiency
  • Oesophagogastroduodenoscopy

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Endoscopic evaluation of significant gastrointestinal lesions in patients with iron deficiency with and without anaemia : A Korean Association for the Study of Intestinal Disease Study. / Park, J. S.; Park, D. I.; Park, S. K.; Choi, J. S.; Kim, Y. H.; Chang, D. K.; Son, H. J.; Kim, J. E.; Kim, J. O.; Lee, S. H.; Kim, H. S.; Sin, J. E.; Lee, S. G.; Lee, S. Y.; Park, S. J.; Park, C. H.; Baek, I. H.; Jang, B. I.; Jeen, Yoon Tae; Huh, K. C.

In: Internal Medicine Journal, Vol. 39, No. 7, 01.07.2009, p. 441-446.

Research output: Contribution to journalArticle

Park, JS, Park, DI, Park, SK, Choi, JS, Kim, YH, Chang, DK, Son, HJ, Kim, JE, Kim, JO, Lee, SH, Kim, HS, Sin, JE, Lee, SG, Lee, SY, Park, SJ, Park, CH, Baek, IH, Jang, BI, Jeen, YT & Huh, KC 2009, 'Endoscopic evaluation of significant gastrointestinal lesions in patients with iron deficiency with and without anaemia: A Korean Association for the Study of Intestinal Disease Study', Internal Medicine Journal, vol. 39, no. 7, pp. 441-446. https://doi.org/10.1111/j.1445-5994.2008.01785.x
Park, J. S. ; Park, D. I. ; Park, S. K. ; Choi, J. S. ; Kim, Y. H. ; Chang, D. K. ; Son, H. J. ; Kim, J. E. ; Kim, J. O. ; Lee, S. H. ; Kim, H. S. ; Sin, J. E. ; Lee, S. G. ; Lee, S. Y. ; Park, S. J. ; Park, C. H. ; Baek, I. H. ; Jang, B. I. ; Jeen, Yoon Tae ; Huh, K. C. / Endoscopic evaluation of significant gastrointestinal lesions in patients with iron deficiency with and without anaemia : A Korean Association for the Study of Intestinal Disease Study. In: Internal Medicine Journal. 2009 ; Vol. 39, No. 7. pp. 441-446.
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abstract = "Background: Although endoscopy is recommended for patients with iron deficiency anaemia, there is, currently, no consensus on the role of endoscopy for iron-deficient patients without anaemia. The goal of this study was to determine the prevalence of serious gastrointestinal (GI) lesions, identified by endoscopy in patients with iron deficiency and anaemia compared with patients with iron deficiency without anaemia. Methods: One thousand five hundred and eighteen patients with a ferritin value of ≤50 ng/mL and a total iron-binding capacity ≥300 mg/dL were retrospectively investigated using oesophagogastroduodenoscopy and colonoscopy between January 2005 and September 2006. The lesions identified were classified as clinically important according to standard predetermined criteria. Results: Among the 1518 cases, 749 patients had anaemia and 769 had normal haemoglobin levels. Clinically important lesions were identified in 24.6{\%} of the patients with anaemia and in 22.8{\%} of the patients without anaemia (P > 0.05). The frequency of lower GI tract lesions (13.6 vs 11.4{\%}, P > 0.05) and upper GI tract lesions (11.9 vs 12.5{\%}, P > 0.05) was similar in the comparisons between the two groups. However, the frequency of malignant GI lesions was higher in the patients with anaemia (5.1 vs 0.7{\%}, P < 0.01). In addition, the patients without anaemia were significantly more likely to have early-stage neoplasia (adenoma, early gastric cancer and Dukes' A and B colon cancer) than were the patients with anaemia (98.4 vs 52.5{\%}, P < 0.01). Conclusion: The results of this study suggest that patients with iron deficiency should undergo endoscopic evaluation of the GI tract, irrespective of whether they have anaemia. The endoscopic evaluation of the GI tract in patients with iron deficiency without anaemia could provide an opportunity for the detection of early-stage neoplasia at a curable stage.",
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AU - Park, D. I.

AU - Park, S. K.

AU - Choi, J. S.

AU - Kim, Y. H.

AU - Chang, D. K.

AU - Son, H. J.

AU - Kim, J. E.

AU - Kim, J. O.

AU - Lee, S. H.

AU - Kim, H. S.

AU - Sin, J. E.

AU - Lee, S. G.

AU - Lee, S. Y.

AU - Park, S. J.

AU - Park, C. H.

AU - Baek, I. H.

AU - Jang, B. I.

AU - Jeen, Yoon Tae

AU - Huh, K. C.

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N2 - Background: Although endoscopy is recommended for patients with iron deficiency anaemia, there is, currently, no consensus on the role of endoscopy for iron-deficient patients without anaemia. The goal of this study was to determine the prevalence of serious gastrointestinal (GI) lesions, identified by endoscopy in patients with iron deficiency and anaemia compared with patients with iron deficiency without anaemia. Methods: One thousand five hundred and eighteen patients with a ferritin value of ≤50 ng/mL and a total iron-binding capacity ≥300 mg/dL were retrospectively investigated using oesophagogastroduodenoscopy and colonoscopy between January 2005 and September 2006. The lesions identified were classified as clinically important according to standard predetermined criteria. Results: Among the 1518 cases, 749 patients had anaemia and 769 had normal haemoglobin levels. Clinically important lesions were identified in 24.6% of the patients with anaemia and in 22.8% of the patients without anaemia (P > 0.05). The frequency of lower GI tract lesions (13.6 vs 11.4%, P > 0.05) and upper GI tract lesions (11.9 vs 12.5%, P > 0.05) was similar in the comparisons between the two groups. However, the frequency of malignant GI lesions was higher in the patients with anaemia (5.1 vs 0.7%, P < 0.01). In addition, the patients without anaemia were significantly more likely to have early-stage neoplasia (adenoma, early gastric cancer and Dukes' A and B colon cancer) than were the patients with anaemia (98.4 vs 52.5%, P < 0.01). Conclusion: The results of this study suggest that patients with iron deficiency should undergo endoscopic evaluation of the GI tract, irrespective of whether they have anaemia. The endoscopic evaluation of the GI tract in patients with iron deficiency without anaemia could provide an opportunity for the detection of early-stage neoplasia at a curable stage.

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KW - Anaemia

KW - Colonoscopy

KW - Iron deficiency

KW - Oesophagogastroduodenoscopy

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