Department of Gastroenterology, University Hospital of Heraklion, Crete, Greece.
J Crohns Colitis. 2011 Oct;5(5):381-91. doi: 10.1016/j.crohns.2011.03.010. Epub 2011 Apr 27.
The main types of anemia in inflammatory bowel disease (IBD) are iron deficiency anemia (IDA) and anemia of inflammatory etiology, or anemia of chronic disease (ACD). In the management of IBD patients with anemia it is essential for the physician to diagnose the type of anemia in order to decide in an evidence-based manner for the appropriate treatment. However, the assessment of iron status in IBD in many cases is rather difficult due to coexistent inflammation. For this assessment several indices and markers have been suggested. Ferritin, seems to play a central role in the definition and diagnosis of anemia in IBD and transferrin, transferrin saturation (Tsat), and soluble transferrin receptors are also valuable markers. All these biochemical markers have several limitations because they are not consistently reliable indices, since they are influenced by factors other than changes in iron balance. In this review, in addition to them, we discuss the newer alternative markers for iron status that may be useful when serum ferritin and Tsat are not sufficient. The iron metabolism regulators, hepcidin and prohepcidin, are still under investigation in IBD. Erythrocytes parameters like the red cell distribution width (RDW) and the percentage of hypochromic red cells as well as reticulocyte parameters such as hemoglobin concentration of reticulocytes, red blood cell size factor and reticulocyte distribution width could be useful markers for the evaluation of anemia in IBD.
炎症性肠病（IBD）中的主要贫血类型是缺铁性贫血（IDA）和炎症性病因贫血，或慢性病贫血（ACD）。在 IBD 伴贫血患者的管理中，医生必须诊断贫血类型，以便基于证据选择适当的治疗方法，这一点至关重要。然而，由于共存的炎症，IBD 中许多情况下的铁状态评估相当困难。为此，已经提出了几种指数和标志物。铁蛋白在 IBD 中定义和诊断贫血方面似乎起着核心作用，转铁蛋白、转铁蛋白饱和度（Tsat）和可溶性转铁蛋白受体也是有价值的标志物。所有这些生化标志物都有一些局限性，因为它们不是始终可靠的指标，因为它们受到除铁平衡变化以外的因素的影响。在这篇综述中，除了这些标志物，我们还讨论了在血清铁蛋白和 Tsat 不足时可能有用的新的铁状态替代标志物。铁代谢调节剂，如铁调素和前铁调素，在 IBD 中仍在研究中。红细胞参数，如红细胞分布宽度（RDW）和低色素红细胞百分比，以及网织红细胞参数，如网织红细胞血红蛋白浓度、红细胞大小因子和网织红细胞分布宽度，可能是评估 IBD 贫血的有用标志物。
