Odhaib Samih A, Mohammed Miaad J, Hammadi Saad S
Adult Endocrinology, Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC) College of Medicine, University of Basrah, Basrah, IRQ.
Diagnostic Radiology, Al-Refaee General Hospital, Thi-Qar Health Directorate, Thi-Qar, IRQ.
Cureus. 2021 Apr 16;13(4):e14524. doi: 10.7759/cureus.14524.
The most common cause for iron deficiency anemia (IDA) in women before menopause is menstrual blood loss. The persistence of digestive symptoms despite iron supplementation is the only indication for gastrointestinal (GI) endoscopy in premenopausal women (PW) with IDA. We evaluated how the GI symptomatology manifestation affects the GI endoscopy diagnostic outcome in this cohort.
This is an observational, multicenter retrospective evaluation of 245 PW admitted for GI endoscopic diagnosis for the etiology of IDA from 2006 to 2016. Baseline measurements included hemoglobin, iron status tests, and red blood corpuscle morphological evaluation. We evaluated the relationships of different endoscopic findings to the severity of IDA, different demographic characteristics, and hospitalization duration.
The mean age was 40±7 years. The duration of hospitalization was neither associated with age nor the IDA severity. The IDA was mild to moderate. More than 53% (n=131) had either a negative study or nonspecific inflammatory changes. Around 16% (n=39) had GI malignancies. There was a significant association between initial GI symptoms with endoscopic GI finding and GI malignancy diagnosis in particular. The relationship loses its power during further assessment by general univariate analysis.
A considerable percentage of anemic PW due to iron deficiency has an endoscopically-diagnosed pathology for IDA determined during GI endoscopy. The GI symptoms' phenotypes were unrelated to the endoscopically-diagnosed GI lesion location, even if they were malignant. Therefore, the determination of IDA severity must be thoroughly and individually determined.
绝经前女性缺铁性贫血（IDA）最常见的原因是月经失血。对于患有IDA的绝经前女性（PW），尽管补充了铁剂，但消化症状持续存在是进行胃肠（GI）内镜检查的唯一指征。我们评估了该队列中GI症状表现如何影响GI内镜诊断结果。
这是一项对2006年至2016年因IDA病因接受GI内镜诊断的245名PW进行的观察性、多中心回顾性评估。基线测量包括血红蛋白、铁状态测试和红细胞形态学评估。我们评估了不同内镜检查结果与IDA严重程度、不同人口统计学特征和住院时间之间的关系。
平均年龄为40±7岁。住院时间与年龄和IDA严重程度均无关。IDA为轻度至中度。超过53%（n = 131）的检查结果为阴性或非特异性炎症改变。约16%（n = 39）患有GI恶性肿瘤。最初的GI症状与内镜下GI检查结果，尤其是与GI恶性肿瘤诊断之间存在显著关联。在进一步的单因素分析评估中，这种关系失去了效力。
相当一部分因缺铁导致贫血的PW在GI内镜检查期间被内镜诊断出患有IDA的病理情况。GI症状的表型与内镜诊断的GI病变位置无关，即使是恶性病变。因此，必须全面且个体化地确定IDA的严重程度。
