P283. Anemia in ulcerative colitis patients - a prospective monocentric study in North-Eastern Romania
G. Dumitrescu, C. Mihai, M. Dranga, O. Nedelciuc, C. Cijevschi Prelipcean, University of Medicine and Pharmacy “Gr. T. Popa”, Iasi, Institute of Gastroenterology and Hepatology, Iasi, Romania
It is well known that anemia is common in inflammatory bowel disease (IBD). There were identified two major causes: iron deficiency and inflammation. Aim: To determine the frequency of anemia and to describe the relationship between the type of anemia and UC characteristics in North-Eastern Romanian patients.
This prospective monocentric study was conducted between March 2011 and October 2012 and included consecutive UC patients seen in The Institute of Gastroenterology and Hepatology Iasi, Romania. Diagnosis of IBD was established based on endoscopic, histological and radiological findings. Demographic data, disease characteristics, and biological parameters were recorded. Blood tests were performed for all patients in Saint Spiridon Hospital laboratory. Anemia was defined as hemoglobin values for males Hb <13 g/dl and females Hb <12 g/dl. Iron deficiency anemia was considered: 80 uc < MCV < 96 uc, ferritin <30 ng/dl, inflammatory anemia: 80 uc < MCV < 96 uc, ferritin >100 mg, CRP >5 mg/l and mixed type anemia 80 uc < MCV < 96 uc, 30 ng/dl < ferritin < 100 ng/dl, CRP >5 mg/l.
One hundred and thirty-nine UC patients were included in this study. Mean age was 45.97±14.73 years, and 84 (60.43%) were male. Fifty-three patients (38.12%) were anemic: iron deficiency anemia was present in 24 patients (45.28%), inflammatory anemia in 12 patients (22.64%) 14 patients (26.41%) had mixed type anemia, and 3 patients had insufficient criteria to be characterised. The whole banch of anemic patients presented extended forms of disease (pancolitis and left side colitis, without statistical differences between the types of anemia (p = 0.185). Iron deficiency anemia, compared to inflammatory anaemia was present especially in patients with long time evolution (49.04±76.17 months vs 15.78±27.58 months, p = 0.048), with often activity spurts that led to a persistent chronic blood loss. The type of anemia in UC patients was also influenced by the disease activity: inflammatory type of anemia was present especially in patients with moderate to severe disease activity compared to iron deficiency anemia who was present in remission or mild activity (p = 0.009). Newly diagnosed UC patients had inflammatory type of anemia compared to the others who presented iron deficiency anemia (p = 0.034).
The anemia is common among patients with UC in North-Eastern Romania. The iron deficiency anemia represents the main cause of anemia and it is strongly correlated with a long time disease duration, a mild activity that leads to a persistent chronic blood loss.