The epidemiology of anemia in pediatric inflammatory bowel disease: Prevalence and associated factors at diagnosis and follow-up and the impact of exclusive enteral nutrition
Background: Anemia is poorly studied in pediatric inflammatory bowel disease. This study explored the epidemiology and associated factors of anemia at diagnosis, after 1 year, and during treatment with exclusive enteral nutrition (EEN). Methods: Three cohorts were included: (1) a representative popu...
| Main Authors: | , , , , , , , , , |
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| Format: | Journal Article |
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2013
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| Online Access: | http://hdl.handle.net/20.500.11937/6425 |
| _version_ | 1848745072706715648 |
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| author | Gerasimidis, K. Barclay, A. Papangelou, A. Missiou, D. Buchanan, E. Tracey, C. Tayler, R. Russell, R. Edwards, Christine McGrogan, P. |
| author_facet | Gerasimidis, K. Barclay, A. Papangelou, A. Missiou, D. Buchanan, E. Tracey, C. Tayler, R. Russell, R. Edwards, Christine McGrogan, P. |
| author_sort | Gerasimidis, K. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Background: Anemia is poorly studied in pediatric inflammatory bowel disease. This study explored the epidemiology and associated factors of anemia at diagnosis, after 1 year, and during treatment with exclusive enteral nutrition (EEN). Methods: Three cohorts were included: (1) a representative population of newly diagnosed inflammatory bowel disease children (n = 184); (2) patients currently receiving care with data available at diagnosis (n = 179) and after 1 year (n = 139); and (3) 84 children treated with EEN. Results: At diagnosis, 72% were anemic. Abnormal inflammatory markers were more common in Crohn's disease with severe anemia (severe versus no anemia [%]: raised C-reactive protein; 89% versus 48%; suboptimal albumin; 97% versus 29%; P , 0.002). Anemic children with Crohn's disease had shorter diagnosis delay and lower BMI than nonanemic patients (severe versus mild versus no anemia, median [interquartile range]; diagnosis delay [months]: 3 [3.9] versus 6 [10] versus 8 [18], P , 0.001; BMI z score [SD]: 21.4 [1.4] versus 21.3 [1.5] versus 20.2 [1.4], P = 0.003). Extensive colitis was associated with severe anemia in ulcerative colitis. The proportion of severely anemic patients decreased from 34% to 9% and mild anemia doubled at 1 year. After EEN, severe anemia decreased (32% to 9%; P , 0.001) and the hemoglobin concentration increased by 0.75 g/dL. This was observed only after 8 weeks of treatment. Disease improvement and low hemoglobin at EEN initiation but not weight gain were associated with hemoglobin improvement. Conclusions: Anemia is high at diagnosis and follow-up and should receive more attention from the clinical team; however, the focus should remain suppression of inflammatory process in active disease. © 2013 Crohn's & Colitis Foundation of America, Inc. |
| first_indexed | 2025-11-14T06:11:33Z |
| format | Journal Article |
| id | curtin-20.500.11937-6425 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T06:11:33Z |
| publishDate | 2013 |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-64252017-09-13T14:42:15Z The epidemiology of anemia in pediatric inflammatory bowel disease: Prevalence and associated factors at diagnosis and follow-up and the impact of exclusive enteral nutrition Gerasimidis, K. Barclay, A. Papangelou, A. Missiou, D. Buchanan, E. Tracey, C. Tayler, R. Russell, R. Edwards, Christine McGrogan, P. Background: Anemia is poorly studied in pediatric inflammatory bowel disease. This study explored the epidemiology and associated factors of anemia at diagnosis, after 1 year, and during treatment with exclusive enteral nutrition (EEN). Methods: Three cohorts were included: (1) a representative population of newly diagnosed inflammatory bowel disease children (n = 184); (2) patients currently receiving care with data available at diagnosis (n = 179) and after 1 year (n = 139); and (3) 84 children treated with EEN. Results: At diagnosis, 72% were anemic. Abnormal inflammatory markers were more common in Crohn's disease with severe anemia (severe versus no anemia [%]: raised C-reactive protein; 89% versus 48%; suboptimal albumin; 97% versus 29%; P , 0.002). Anemic children with Crohn's disease had shorter diagnosis delay and lower BMI than nonanemic patients (severe versus mild versus no anemia, median [interquartile range]; diagnosis delay [months]: 3 [3.9] versus 6 [10] versus 8 [18], P , 0.001; BMI z score [SD]: 21.4 [1.4] versus 21.3 [1.5] versus 20.2 [1.4], P = 0.003). Extensive colitis was associated with severe anemia in ulcerative colitis. The proportion of severely anemic patients decreased from 34% to 9% and mild anemia doubled at 1 year. After EEN, severe anemia decreased (32% to 9%; P , 0.001) and the hemoglobin concentration increased by 0.75 g/dL. This was observed only after 8 weeks of treatment. Disease improvement and low hemoglobin at EEN initiation but not weight gain were associated with hemoglobin improvement. Conclusions: Anemia is high at diagnosis and follow-up and should receive more attention from the clinical team; however, the focus should remain suppression of inflammatory process in active disease. © 2013 Crohn's & Colitis Foundation of America, Inc. 2013 Journal Article http://hdl.handle.net/20.500.11937/6425 10.1097/MIB.0b013e31829ed855 restricted |
| spellingShingle | Gerasimidis, K. Barclay, A. Papangelou, A. Missiou, D. Buchanan, E. Tracey, C. Tayler, R. Russell, R. Edwards, Christine McGrogan, P. The epidemiology of anemia in pediatric inflammatory bowel disease: Prevalence and associated factors at diagnosis and follow-up and the impact of exclusive enteral nutrition |
| title | The epidemiology of anemia in pediatric inflammatory bowel disease: Prevalence and associated factors at diagnosis and follow-up and the impact of exclusive enteral nutrition |
| title_full | The epidemiology of anemia in pediatric inflammatory bowel disease: Prevalence and associated factors at diagnosis and follow-up and the impact of exclusive enteral nutrition |
| title_fullStr | The epidemiology of anemia in pediatric inflammatory bowel disease: Prevalence and associated factors at diagnosis and follow-up and the impact of exclusive enteral nutrition |
| title_full_unstemmed | The epidemiology of anemia in pediatric inflammatory bowel disease: Prevalence and associated factors at diagnosis and follow-up and the impact of exclusive enteral nutrition |
| title_short | The epidemiology of anemia in pediatric inflammatory bowel disease: Prevalence and associated factors at diagnosis and follow-up and the impact of exclusive enteral nutrition |
| title_sort | epidemiology of anemia in pediatric inflammatory bowel disease: prevalence and associated factors at diagnosis and follow-up and the impact of exclusive enteral nutrition |
| url | http://hdl.handle.net/20.500.11937/6425 |