由质子泵抑制剂引起的铁吸收不良导致的缺铁性贫血。
Iron deficiency anemia from iron malabsorption caused by proton pump inhibitors.
作者信息
Boxer Michael
机构信息
Arizona Oncology Associates Tucson Arizona USA.
出版信息
EJHaem. 2020 Sep 1;1(2):548-551. doi: 10.1002/jha2.96. eCollection 2020 Nov.
BACKGROUND
Iron deficiency anemia without evidence for blood loss can present a diagnostic challenge. Proton pump inhibitors have been associated with iron deficiency anemia for many years, yet the relationship between the two until recently was not fully understood. Treatment recommendations are lacking.
METHODS AND METHODS
This study evaluated 43 iron deficient patients who were taking proton pump inhibitors, 41 of whom were unresponsive to oral iron, and for whom no etiology for the iron deficiency could be found. Two patients who had hereditary hemochromatosis never were treated with oral iron.
RESULTS
Forty-three patients taking a proton pump inhibitor had elevated serum gastrin ≥100 pg/mL. Upon treatment with intravenous iron, 95% (41/43) responded with increased hemoglobin concentration ≥2 g/dL. Improvements were also achieved in the mean corpuscular volume, ferritin, and transferrin saturation.
CONCLUSIONS
These findings suggest that proton pump inhibitors have been an under-recognized cause for iron deficiency anemia and need to be considered in patients who are taking a proton pump inhibitor. The iron deficiency does correct with intravenous iron replacement.
背景
无失血证据的缺铁性贫血可能带来诊断挑战。质子泵抑制剂与缺铁性贫血相关多年，但直到最近两者之间的关系仍未完全明确。目前缺乏治疗建议。
方法
本研究评估了43例正在服用质子泵抑制剂的缺铁患者，其中41例对口服铁剂无反应，且未发现缺铁的病因。2例遗传性血色素沉着症患者从未接受过口服铁剂治疗。
结果
43例服用质子泵抑制剂的患者血清胃泌素升高≥100 pg/mL。静脉补铁治疗后，95%（41/43）患者血红蛋白浓度升高≥2 g/dL，平均红细胞体积、铁蛋白和转铁蛋白饱和度也有所改善。
结论
这些发现表明质子泵抑制剂一直是缺铁性贫血未被充分认识的病因，在服用质子泵抑制剂的患者中需要考虑这一因素。缺铁性贫血可通过静脉补铁得到纠正。
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