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病例报告:开始口服补铁后迅速发生缺血性胃炎。

Case report: Rapid onset, ischemic-type gastritis after initiating oral iron supplementation.

作者信息

Koch Regina M, Tchernodrinski Stefan, Principe Daniel R

机构信息

Department of Medicine, University of Illinois College of Medicine, Chicago, IL, United States.

Medical Scientist Training Program, University of Illinois College of Medicine, Chicago, IL, United States.

出版信息

Front Med (Lausanne). 2022 Nov 3;9:1010897. doi: 10.3389/fmed.2022.1010897. eCollection 2022.

Abstract

Oral iron supplements are commonly administered to patients with chronic iron deficiency anemia. This approach is generally well-tolerated, causing only mild adverse effects. Rarely, oral iron supplementation can cause more severe symptoms, one of the most concerning being acute gastritis. This predominantly affects elderly patients and is extremely uncommon in young, otherwise healthy people. Here, we report the case of a 43-year-old woman who presented with upper gastrointestinal (GI) symptoms and iron deficiency anemia and was started on oral iron supplementation following the resolution of her acute symptoms. She soon re-presented with a severe, -negative gastritis with iron deposition on histology. These new onset symptoms resolved rapidly with cessation of iron supplements, consistent with iron pill gastritis. In addition to the limited body of literature describing iron pill gastritis, this case serves as a reminder that any patient receiving oral iron supplementation is at a potential risk for gastritis, particularly in the setting of an ongoing GI pathology. Hence, it is important to provide continued follow-up for patients receiving iron supplementation regardless of age or comorbidity, particularly in the weeks following the start of the treatment.

摘要

口服铁补充剂常用于治疗慢性缺铁性贫血患者。这种方法通常耐受性良好,仅会引起轻微的不良反应。口服铁补充剂很少会导致更严重的症状,其中最令人担忧的一种是急性胃炎。这主要影响老年患者,在年轻且其他方面健康的人群中极为罕见。在此,我们报告一例43岁女性病例,该患者出现上消化道(GI)症状和缺铁性贫血,在急性症状缓解后开始口服铁补充剂治疗。她很快再次出现严重的、组织学上有铁沉积的阴性胃炎。停用铁补充剂后,这些新出现的症状迅速缓解,符合铁剂性胃炎。除了描述铁剂性胃炎的文献有限外,该病例还提醒我们,任何接受口服铁补充剂治疗的患者都有患胃炎的潜在风险,尤其是在存在持续的胃肠道病变的情况下。因此,无论患者年龄或合并症如何,对接受铁补充剂治疗的患者进行持续随访都很重要,尤其是在治疗开始后的几周内。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bedc/9669597/a179c163aa5a/fmed-09-1010897-g001.jpg

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