Quera Rodrigo, Núñez Paulina, Flores Lilian
Centro de Enfermedades Digestivas, Universidad de los Andes, Santiago, Chile.
Departamento de Medicina Interna, Facultad Medicina Occidente, Universidad de Chile, Santiago, Chile.
Rev Med Chil. 2022 Aug;150(8):1063-1074. doi: 10.4067/S0034-98872022000801063.
Anemia is the most common extraintestinal manifestation of inflammatory bowel disease (IBD). Although there are several causes of anemia in IBD, the two most frequent etiologies are iron deficiency anemia and anemia of chronic disease. Despite the high prevalence of anemia in IBD and its significant impact on patient's quality of life, this complication is still underdiagnosed and undertreated by providers. Active screening for anemia, structured assessment, comprehensive management, and multidisciplinary collaboration are needed in IBD patients. The cornerstone of anemia management depends on the underlying etiology along with normalization of inflammatory activity. Although, oral iron is effective for the treatment of mild iron deficiency-related anemia, intravenous iron formulations have a good safety profile and can be used as first-line therapy in patients with active IBD, severe anemia and previous intolerance prior to oral iron. After proper treatment of anemia, careful monitoring is necessary to prevent its recurrence. Herein, we discuss the etiology, screening, diagnosis, therapy selection, and follow-up for anemia in IBD.
贫血是炎症性肠病（IBD）最常见的肠外表现。尽管IBD中贫血有多种原因，但最常见的两种病因是缺铁性贫血和慢性病贫血。尽管IBD中贫血的患病率很高，且对患者的生活质量有重大影响，但这一并发症仍未得到充分诊断和治疗。IBD患者需要积极筛查贫血、进行结构化评估、综合管理以及多学科协作。贫血管理的基石取决于潜在病因以及炎症活动的正常化。虽然口服铁剂对治疗轻度缺铁性贫血有效，但静脉铁剂安全性良好，可作为活动性IBD、严重贫血以及既往对口服铁剂不耐受患者的一线治疗。贫血经过适当治疗后，需要仔细监测以防止复发。在此，我们讨论IBD中贫血的病因、筛查、诊断、治疗选择及随访。
