Recombinant human erythropoietin for treatment of anemia of chronic disease in children with Crohn's disease☆,☆☆,★,★★
Section snippets
Entry Criteria
Children recruited for the study were 1 to 17 years of age with Crohn's disease, with a stable therapy regimen, who had ACD refractory to oral iron therapy. A stable therapy regimen was defined as one with no change in antiinflammatory medications or dosage for at least 3 months before treatment with rH-EPO. Anemia was defined as a hemoglobin level 2.5 SD or more below the mean for age and sex,9 and was considered refractory to iron therapy (6 mg/kg per day) if the elevation of hemoglobin was
Results
A total of 109 children with inflammatory bowel disease were assessed during an 8-month period. Of these, four children with Crohn's disease, ages 2.6 to 17 years (mean age 12.0 year), had ACD and met the inclusion criteria. Crohn's disease had been diagnosed 12 months to 7 years before starting rH-EPO therapy. All had endoscopic and histologic evidence of Crohn's disease involving the colon and terminal ileum, and two had antroduodenitis at the time of diagnosis. All 4 patients were taking
Discussion
Intestinal blood loss and chronic inflammation are regarded as the most important mechanisms in the pathogenesis of anemia in Crohn's disease.13 Patients with Crohn's disease who have anemia may have a combination of both mechanisms in different proportions, and therefore an increased iron intake will correct the anemia in some but not all patients.13 It has been estimated that up to 51% of adults with Crohn's disease had ACD.14
The pathogenesis of ACD is not yet fully established. From in vitro
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Cited by (29)
Recombinant human erythropoietin in patients with inflammatory bowel disease and refractory anemia: A 15-year single center experience
2012, Journal of Crohn's and ColitisCitation Excerpt :However, in IBD anemic patients this EPO increase is inadequate in relation to the degree of anemia.16,17 Correction of anemia through the administration of oral or intravenous (I.V.) iron and/or supplemental recombinant human EPO or darbepoetin19 in refractory patients has been shown to improve hematologic indices and quality of life.20–22 In this study we aimed to report our experience on patients' response and safety to EPO administration in a cohort of refractory to I.V. iron anemic patients with IBD.
Anemia in inflammatory bowel disease - The role of recombinant human erythropoietin
2000, European Journal of Internal MedicineA Systematic Review of Micronutrient Deficiencies in Pediatric Inflammatory Bowel Disease
2019, Inflammatory Bowel DiseasesPortuguese consensus on the diagnosis, prevention and treatment of anaemia in inflammatory bowel disease
2016, Acta Medica PortuguesaAnemia in inflammatory bowel disease: A neglected issue with relevant effects
2014, World Journal of Gastroenterology
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From the Division of Gastroenterology and Department of Pathology, University of British Columbia and B.C. Children's Hospital, Vancouver, British Columbia, Canada.
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Supported by a grant from Ortho-McNeil, North York, Ontario, Canada.
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Reprint requests: David M. Israel, MD, Division of Pediatric Gastroenterology, University of British Columbia, 4480 Oak St., Vancouver, BC, Canada V6H 3V4.
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