The Spectrum of Small Intestinal Lesions in Patients with Unexplained Iron Deficiency Anemia Detected by Video Capsule Endoscopy

Autor: Antonella Contaldo, Enzo Ierardi, F. Albano, Giuseppe Losurdo, Mariabeatrice Principi, Andrea Iannone, Michele Barone, Alfredo Di Leo
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
Medicine (General)
Multivariate analysis
genetic structures
NSAIDs
Gastroenterology
Capsule Endoscopy
anemia
videocapsule endoscopy
obscure occult bleeding
PPIs
Hospitals
University
Tertiary Care Centers
Risk Factors
Intestine
Small
Prevalence
Aged
80 and over
Univariate analysis
medicine.diagnostic_test
Anemia
Iron-Deficiency
Anti-Inflammatory Agents
Non-Steroidal
General Medicine
Middle Aged
Occult Blood
Female
medicine.symptom
Gastrointestinal Hemorrhage
Adult
medicine.medical_specialty
medicine.drug_class
Anemia
Proton-pump inhibitor
Article
Lesion
Young Adult
R5-920
Internal medicine
medicine
Humans
Aged
Retrospective Studies
Inpatients
business.industry
Proton Pump Inhibitors
medicine.disease
Endoscopy
Logistic Models
Iron-deficiency anemia
Multivariate Analysis
Hemoglobin
business
Zdroj: Medicina, Vol 55, Iss 3, p 59 (2019)
Medicina
Volume 55
Issue 3
Medicina; Volume 55; Issue 3; Pages: 59
Popis: Background and objectives: Video-capsule endoscopy (VCE) has shown a large range (38&ndash
83%) of diagnostic yield in unexplained iron deficiency anemia (IDA) and obscure-occult bleeding. Therefore, we retrospectively investigated the VCE-detected spectrum and the prevalence of small bowel injuries and associated risk factors in inpatients with both of the above reported conditions. Methods: We selected inpatients with IDA (hemoglobin <
12 g/dL in women, <
13 g/dL in men) and obscure-occult bleeding. We excluded VCE indications other than IDA. Complete medical histories and laboratory tests were collected. All subjects underwent PillCam SB2/SB3. The VCE feature Lewis score was calculated when appropriate. We used the t-test and Fisher&rsquo
s exact test for continuous and categorical variables, respectively, in univariate analysis. For multivariate analysis, we used binomial logistic regression. Results: We retrieved 109 patients (female:male ratio of 53:56
age 63.4 ±
18.9 years). Eighty patients (73.4%) showed &ge
1 small bowel lesions. The Lewis score was calculated in 41 patients: 13 (31.7%) showed a mild (<
135) and 28 (68.3%) a moderate-severe (135&ndash
790 and >
790, respectively) score. In univariate analysis, the small bowel transit time (6.2 ±
2.9 versus 5.2 ±
2.1 h
p = 0.049) and non-steroidal anti-inflammatory drug use for at least two weeks (17.5% versus 0%
p = 0.01) were significantly higher in subjects with injuries. These associations were not confirmed at multivariate analysis. The severity of a lesion directly correlated with proton pump inhibitor (PPI) use and duration (not confirmed in multivariate analysis). VCE can reveal the source of obscure-occult bleeding in a high percentage of unexplained IDAs. A wide spectrum of endoscopic pictures may be found. Known as well as supposed risk factors for small bowel lesions may be detected.
Databáze: OpenAIRE
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