P289. Anaemia and iron deficiency in pediatric inflammatory bowel disease
J. Martín de Carpi1, M. Pina Jover2, G. Pujol Muncunill2, V. Varea Calderón2, 1Hospital Sant Joan de Déu, Barcelona, Spain, Pediatric Inflammatory Bowel Disease Unit, Barcelona, Spain, 2Hospital Sant Joan de Deu, Pediatric Gastroenterology and Nutrition Unit, Barcelona, Spain
Anaemia and iron deficiency are prevalent situations in pediatric Inflammatory Bowel Disease (IBD). Its persistence throughout the follow-up and its relationship with inflammatory activity has not been fully studied. However, correction of anaemia in adult patients improves their quality of life. Our aim was to calculate the prevalence of anaemia and iron deficiency in paediatric IBD at diagnosis and throughout the first year of follow-up, as well as the response to iron therapy and the disease outcomes.
IBD pediatric patients diagnosed in our centre between January 2011 and January 2012 were studied. Laboratory data at diagnosis, 8 weeks, 6 months and at one year of follow-up were retrospectively recorded. Anaemia was defined using WHO standards according to age and gender. Activity index scores (PCDAI/PUCAI) and information about therapeutic approach were also collected.
Data from 48 patients [31 Crohn's disease (CD) and 17 ulcerative colitis (UC)] were obtained. 70.8% of our IBD children were anaemic at diagnosis. Concerning CD, 71% of children had iron-deficiency anaemia (IDA) and 13% iron deficiency without anaemia. 70.5% of children with UC had IDA, and 23.5% iron deficiency without anaemia. 85% of children with IDA were treated with iron therapy (mean: 4.6 months). 41% of children recovered from IDA after induction therapy (8 weeks), 32% recovered at 6 months, and 18% recovered at 12 months follow up. Anaemia and iron status recovery was parallel to inflammatory markers amelioration (CRP, ESR) and improvement in activity scores (PCDAI, PUCAI). Only 6.2% (3 patients) with IDA did not recover at the end of the first year, despite being clinically asymptomatic.
Chronic anaemia and iron-deficiency are common in pediatric IBD. Intensive iron treatment and effective control of underlying inflammation contribute to IDA resolution in our cohort. However, reliable diagnostic criteria to identify children who may be suitable for therapeutic intervention are needed.