GASTROENTEROLOGY ARTICLE OF THE WEEK
August 14, 2008
Gisbert JP, Gomollon F. Common misconceptions in the diagnosis and management of anemia in inflammatory bowel disease. Am J Gastroenterol 2008;103:1292-1307
1. Difficulties in diagnosing the cause of anemia in IBD include
a. Azathioprine can cause microcytosis
b. Transferrin levels are usually increased in chronic inflammation
c. Iron deficiency can be associated with normal red cell size in patients taking
6-MP
d. Sulfasalzine interferes with folate absorption
True or False
2. Anemia is one of the most common extra-intestinal manifestations of IBD, up to 45% may have iron deficiency.
3. In the presence of active IBD, iron deficiency may be present even if ferritin levels are normal.
4. The lower the ferritin, the higher the daily dose of iron that should be administered to achieve prompt correction of iron deficiency
5. IV iron, when administered as iron sucrose, has a low incidence of adverse events.
6. A trial of iron supplementation should be given to IBD patients with anemia even if the ferritin is normal.
7. Iron supplements given as a tid dosing can worsen IBD symptoms in some cases
8. Infliximab therapy usually causes anemia