Division of Gastroenterology and Hepatology, University Hospital Zürich , Zürich , Switzerland.
Division of Gastroenterology and Hepatology, University Hospital Zürich , Zürich , Switzerland ; Division of Gastroenterology, Triemlispital , Zürich , Switzerland.
Front Med (Lausanne). 2015 Jan 19;1:58. doi: 10.3389/fmed.2014.00058. eCollection 2014.
Anemia is one of the most frequent complications and/or extraintestinal manifestations of inflammatory bowel disease (IBD). Iron deficiency is the most important cause of anemia in Crohn's disease and ulcerative colitis patients. Iron deficiency even without anemia may impact the quality of life of our IBD patients. In the last 10 years, the understanding of the pathology of iron-deficiency anemia and "anemia of chronic diseases" has increased; new diagnostic tools have been developed and new therapeutic strategies have been discussed. Hepcidin has been identified to be a central regulator of iron absorption from the intestine and of iron plasma levels. Hepcidin is regulated by iron deficiency but also as an acute phase protein by pro-inflammatory mediators such as interleukin-6. Innovative diagnostic tools have not been introduced in clinical routine or are not available for routine diagnostics. As iron substitution therapy is easy these days with a preference for intravenous substitution, the impact of differential diagnosis of anemia in IBD patients is underestimated.
贫血是炎症性肠病（IBD）最常见的并发症和/或肠道外表现之一。缺铁是克罗恩病和溃疡性结肠炎患者贫血的最重要原因。即使没有贫血，缺铁也会影响我们的 IBD 患者的生活质量。在过去的 10 年中，人们对缺铁性贫血和“慢性病性贫血”的病理学有了更多的了解；开发了新的诊断工具，并讨论了新的治疗策略。铁调素被确定为肠道铁吸收和铁血浆水平的中央调节剂。铁调素受缺铁的调节，也作为急性期蛋白受到白细胞介素-6 等促炎介质的调节。创新的诊断工具尚未引入临床常规或无法用于常规诊断。由于目前铁替代治疗很容易，并且更倾向于静脉替代治疗，因此低估了 IBD 患者贫血的鉴别诊断的影响。
