The prevalence of anemia and iron deficiency in IBD outpatients in Scandinavia.
Bager P, Befrits R, Wikman O et al.
Estimates of anemia and iron deficiency in patients with inflammatory bowel disease (IBD) vary widely in the literature, and most published reports predate the widespread use of anti-tumor necrosis factor-α treatment. The authors of this paper present a cross-sectional survey of 429 IBD patients attending clinics in Denmark, Sweden, and Norway. All centers consecutively included approximately 5% of their IBD patients in a 1-week period during either June or October to December 2009. All patients were included in the study when they attended the clinic, regardless of disease activity. Six pregnant women and two patients for whom a hemoglobin test was not available were excluded, leaving 429 patients for the analysis. The data collected included hemoglobin, ferritin, vitamin B12, folic acid, and C-reactive protein (CRP) levels. Patients were classified as having anemia or no anemia, iron deficiency with anemia, or iron deficiency without anemia, and the classification of the anemia was based on analysis of CRP, ferritin, folic acid, and vitamin B12. The combination of an elevated CRP with a ferritin level >100 was regarded to be indicative of anemia of chronic disease, and a sub-normal ferritin level in combination with a normal CRP level was regarded to be indicative of anemia due to iron deficiency.