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P601. Prevalence of anemia in Serbian patients with inflammatory bowel disease


Anemia is very common in patients with inflammatory bowel disease (IBD). Anemia in IBD is complex and commonly represents a particular example of the combination of iron deficiency anemia and anemia of chronic diseases. Other causes of anemia such as vitamin B (12) and folate deficiency is the third common type of anemia that is frequently seen in Crohn's disease (CD), while haemolysis and various other causes like anemia induced by drugs (sulfasalazine, thiopurines) occur less frequantly in IBD patients [1]. However, the reported prevalence of anemia has been markedly variable, ranges from 16% to 74% [2].

The aim of this prospective study was to analyze the association between different types of anemia and IBD in Serbian tertiary referral center.


We carried out a prospective study from June 2009 to October 2013, including 301 consecutive IBD patients (M 143). Serum levels of hemoglobin, mean corpuscular volume, ferritin, transferrin saturation, folic acid, vitamin B (12), lactate dehydrogenase, haptoglobin, and C-reactive protein were analyzed in all patients with IBD. The hemoglobin levels were considered according to gender.


171 patients with ulcerative colitis (UC) and 130 patients with CD, mean age 41±15 years (range 18–76), were enrolled. The prevalence of anemia in total IBD patients was 81% (84% for UC and 78% for CD). 89% (134) of female patients with IBD had anemia, and 77% (110) of males.

Among the 244 anemic IBD patients 206 had active disease and 38 non active disease.

Most of our patients with anemia had iron deficiency anemia, serum ferritin was low in 57% (139), anemia of chronic diseases was present in 34% (72) and folic acid was low in 10% (25). Vitamin B (12) deficiency was present in patients with CD 3% (8), while most patients with vitamin B (12) abnormalities had a prior ileal or ileocolonic resection 75% (6).


Anemia is a frequent complication in Serbian patients with IBD. In our study 81% IBD patients had anemia, and more than half of these patients had iron deficiency anemia. Vitamin B (12) abnormalities are common in CD patients with prior ileal or ileocolonic resection. Our results suggest that iron deficiency is the main cause of anemia in IBD patients.

1. Gasche C, Berstad A, Befrits R, Beglinger C, Dignass A, Erichsen K, Gomollon F, Hjortswang H, Koutroubakis I, Kulnigg S, Oldenburg B, Rampton D, Schroeder O, Stein J, Travis S and Van Assche G., (2007), Guidelines on the Diagnosis and Management of Iron, Inflamm Bowel Dis.

2. Gisbert JP, Gomollón F, (2008), Common Misconceptions in the Diagnosis and, Am J Gastroenterol.

  • Written by:

    D. Mijac, G. Jankovic, M. Krstic, D. Culafic, I. Rankovic, D. Tomic, S. Djuranovic, Belgrade University, Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, Belgrade, Serbia