P294 Iron-deficiency without anemia in Crohn's disease: what are the predictive factors of recovery?
Cúrdia Gonçalves T.*1, Monteiro S.1, Barbosa M.1, Moreira M.J.1, Cotter J.1,2,3
1Hospital da Senhora da Oliveira, Gastroenterology, Guimarães, Portugal 2University of Minho, Life and Health Sciences Research Institute, School of Medicine, Braga, Portugal 3ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
Iron-deficiency without anemia (IDWA) is a common but little explored clinical situation in patients with Crohn's Disease (CD). Despite being at risk for developing iron-deficient anemia, some patients will present recovery of the IDWA during the follow-up. The aim of this study was to identify predictive factors of IDWA recovery after one year of follow-up.
Retrospective single-center evaluation of patients with CD who had at least on episode of IDWA between January/2011 and December/2014, with a minimum follow-up of 1 year. Iron-deficiency was defined as a serum ferritin value below 30 μg/L in the absence of inflammation or when serum ferritin value was between 30–100μg/L and inflammation was evident. Two groups of patients (those who had recovery of IDWA and those who maintained IDWA or developed anemia) were compared regarding demographic and clinical characteristics using the χ2 and Fisher's exact tests.
From the 136 identified patients with CD and IDWA, 97 (71,3%) were women. During the following year after the identification of IDWA, 37 patients (27,2%) recovered the serum ferritin levels, 24 (17,6%) developed iron-deficient anemia, and 75 (55,2%) had persistent IDWA. Recovery of the IDWA was significantly more common in men (p=0.006), in patients with serum ferritin values between 30–100μg/L (p=0.035), in patients with a penetrating behavior of the disease (p=0.026), and in those with perianal disease (p=0.029). No significant differences were found regarding disease extension (p=0.121), upper gastrointestinal tract involvement (p=0.908), age at the diagnosis (p=0.913), smoking habits (p=0.236) or family history of inflammatory bowel diseases (p=0.313). The use of iron supplements was not more common in those patients who had recovery of IDWA during the follow-up (p=0.683).
Only a fourth of the patients will present recovery of IDWA during the following year, which is more common in men and in those with higher levels of serum ferritin. These findings emphasize the need of a close monitoring of IDWA, particularly in women or in patients with lower serum ferritin values, in whom the recovery is not so common.