Address correspondence and reprint requests to Patrick F. van Rheenen, MD, PhD, Pediatric Gastroenterology, Department of Pediatrics, University Medical Center Groningen, PO Box 30001, 9700 RB Groningen, The Netherlands (e-mail: [email protected]).Search for more papers by this author

Lise PM Pels,

Lise PM Pels

Department of Pediatrics, University Medical Center Groningen, The Netherlands

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Els Van de Vijver,

Els Van de Vijver

Department of Pediatrics, University Medical Center Groningen, The Netherlands

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Herman J Waalkens,

Herman J Waalkens

Department of Pediatrics, Martini Hospital, Groningen, The Netherlands

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Jan Uitentuis,

Jan Uitentuis

Department of Pediatrics, Medical Center Leeuwarden, Leeuwarden, The Netherlands

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Gieneke Gonera-de Jong,

Gieneke Gonera-de Jong

Department of Pediatrics, Wilhelmina Hospital, Assen, The Netherlands

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Lidy AT van Overbeek,

Lidy AT van Overbeek

Department of Pediatrics, Scheper Hospital, Emmen, The Netherlands

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Obbe F Norbruis,

Obbe F Norbruis

Department of Pediatrics, Isala Clinics, Zwolle, The Netherlands

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Edmond HHM Rings,

Edmond HHM Rings

Department of Pediatrics, University Medical Center Groningen, The Netherlands

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Patrick F van Rheenen,

Corresponding Author

Patrick F van Rheenen

[email protected]

Department of Pediatrics, University Medical Center Groningen, The Netherlands

First published: 01 December 2010

https://doi.org/10.1097/MPG.0b013e3181da4d8b

Citations: 23

The authors report no conflicts of interest.

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ABSTRACT

Background and Objective:

Allowing children with inflammatory bowel disease (IBD) to live with subnormal hemoglobin (Hb) levels affects their quality of life. The therapeutic approach to normalize Hb varies according to the cause of IBD-associated anemia. In exclusive iron-deficiency anemia (IDA) repletion of iron stores is obligatory, whereas controlling inflammation is the treatment of choice for anemia of chronic disease (ACD). In daily practice the focus is on control of intestinal inflammation, and spontaneous hematological recovery is awaited. The aim of the present study was to evaluate the hematological effect of “expectant management” on newly diagnosed pediatric patients with IBD with anemia.

Patients and Methods:

Medical records of children with IBD were reviewed. Study endpoints were the difference in Hb from the moment of IBD diagnosis (T₀) to the end of the induction phase (T₁), and time until normalization of Hb, stratified for the type of anemia at T₀.

Results:

A total of 103 children were included in the study, of whom 80 (78%) had anemia at T₀. Exclusive IDA was found in 58% of them. Expectant management caused a modest increase in Hb between T₀ and T₁ for both types of anemia (IDA 0.4 mmol/L; ACD 0.5 mmol/L), but 65 of 80 children (81%) still had anemia at T₁. The proportion of children with exclusive IDA had increased to 74%. One third of the cases initially classified as having ACD had progressed to exclusive IDA. There was no significant difference in time until normalization of Hb between children with exclusive IDA and ACD. Twelve months after IBD diagnosis 24% of the group initially diagnosed as having exclusive IDA and 50% of the ACD group were still anemic.

Conclusions:

Hematological recovery in children with IBD-associated anemia is slow with expectant management, regardless of the type of anemia at T₀. Present results underline the need for a more active approach to improve Hb.

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Volume51, Issue6

December 2010

Pages 708-713

Slow Hematological Recovery in Children With IBD-associated Anemia in Cases of “Expectant Management”

ABSTRACT

Background and Objective:

Patients and Methods:

Results:

Conclusions:

REFERENCES

Citing Literature

References

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Slow Hematological Recovery in Children With IBD-associated Anemia in Cases of “Expectant Management”

ABSTRACT

Background and Objective:

Patients and Methods:

Results:

Conclusions:

REFERENCES

Citing Literature

References

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