Martin Julia, Radeke Heinfried H, Dignass Axel, Stein Jürgen
a Crohn Colitis Clinical Research Center Rhein-Main , Frankfurt/Main , Germany.
b Department of Pharmaceutical Chemistry , University of Frankfurt , Frankfurt/Main , Germany.
Expert Rev Gastroenterol Hepatol. 2017 Jan;11(1):19-32. doi: 10.1080/17474124.2017.1263566. Epub 2016 Nov 29.
Anemia is a common extraintestinal manifestation in IBD patients and considerably impacts disease prognosis, hospitalization rates and time lost from work. While iron deficiency anemia is predominant, combinations of hematimetric and biochemical markers enable detection and targeted therapy of other etiologies including vitamin B12/folic acid deficiencies, hemolysis, myelosuppression and pharmacotherapies. Areas covered: Current literature was searched for articles focusing on etiology, diagnostics and therapy of anemia in IBD. In the light of their own experience, the authors describe the physiology of anemia in IBD and present current evidence endorsing diagnostic and therapeutic options, focusing particularly on non-iron-related etiologies. Expert commentary: Anemia in IBD is polyetiological, reaching far beyond iron deficiency anemia. While clinicians need to be aware of the increasing pallet of diagnostic tools and therapeutic options, detailed studies are needed to develop more convenient test procedures, long-term treatment and monitoring strategies, and unified guidelines for daily practice.
贫血是炎症性肠病(IBD)患者常见的肠外表现,对疾病预后、住院率和工作时间损失有重大影响。虽然缺铁性贫血最为常见,但血液学和生化指标的综合运用有助于检测和针对性治疗其他病因,包括维生素B12/叶酸缺乏、溶血、骨髓抑制和药物治疗。涵盖领域:检索当前文献,查找聚焦于IBD患者贫血病因、诊断和治疗的文章。根据自身经验,作者描述了IBD患者贫血的生理机制,并提供支持诊断和治疗选择的当前证据,尤其关注非缺铁相关病因。专家评论:IBD患者的贫血病因多样,远不止缺铁性贫血。虽然临床医生需要了解越来越多的诊断工具和治疗选择,但仍需要详细研究以开发更便捷的检测程序、长期治疗和监测策略,以及统一的日常实践指南。