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Gut 2004;53:1190-1197
© 2004 by BMJ Publishing Group Ltd & British Society of Gastroenterology


REVIEW

Iron, anaemia, and inflammatory bowel diseases

C Gasche1, M C E Lomer2, I Cavill3, G Weiss4

1 Department of Medicine 4, Division of Gastroenterology and Hepatology, Medical University Vienna, Austria
2 Gastrointestinal Laboratory, the Rayne Institute, St. Thomas’ Hospital, London, UK
3 Department of Haematology, University of Wales, College of Medicine, Cardiff, UK
4 Department of General Internal Medicine, Clinical Immunology and Infectious Diseases, University of Innsbruck, Austria

Correspondence to:
Correspondence to:
Dr C Gasche
Allgemeines Krankenhaus Wien, Innere Medizin 4, Wahringer Gurtel 18, Vienna, A-1090, Austria; christoph.gasche{at}meduniwien.ac.at

Iron deficiency anaemia is one of the most common disorders in the world. Also, one third of inflammatory bowel disease (IBD) patients suffer from recurrent anaemia. Anaemia has significant impact on the quality of life of affected patients. Chronic fatigue, a frequent IBD symptom itself, is commonly caused by anaemia and may debilitate patients as much as abdominal pain or diarrhoea. Common therapeutic targets are the mechanisms behind anaemia of chronic disease and iron deficiency. It is our experience that virtually all patients with IBD associated anaemia can be successfully treated with a combination of iron sucrose and erythropoietin, which then may positively affect the misled immune response in IBD.


Abbreviations: IBD, inflammatory bowel disease; ID, iron deficiency; IDA, iron deficiency anaemia; TPMT, thiopurine methyltransferase; MCV, mean cell volume; Epo, erythropoietin; ACD, anaemia of chronic disease; RBC, red blood cell; NRAMP-1, natural resistance associated macrophage protein; IFN-{gamma}, interferon {gamma}; TNF-{alpha}, tumour necrosis factor {alpha}; NO, nitric oxide; RES, reticuloendothelial system

Keywords: inflammatory bowel diseases; anaemia; iron deficiency; anaemia of chronic disease; iron sucrose; erythropoietin




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