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Small bowel lesions in patients with iron deficiency anaemia without overt bleeding: a multicentre study

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Abstract

The diagnostic work-up in iron deficiency anaemia (IDA) patients can be challenging when bleedings or malabsorption are not clinically manifest. Lesions on the small bowel mucosa may cause IDA. We evaluated the prevalence of lesions on the small bowel mucosa detected at Videocapsule Endoscopy (VCE) in IDA patients following negative upper and lower endoscopies. Clinical and endoscopic data collected in 5 centres were retrieved. Lesions with a high bleeding potential (P2) were computed, and predictive factors investigated at multivariate analysis. By considering data of 230 patients, the endoscopic examination detected a total of 96 (41.7%; 95% CI: 35.4–48.1) P2 lesions on the small bowel mucosa, including 4 (1.7%) cancers. The use of non-steroidal anti-inflammatory drugs was found to be the only associated factor at both univariate (OR: 5.7, 95% CI: 2.4–13.4; P <0.001) and multivariate (OR: 2.8; 95% CI: 1.7–3.9, P <0.01) analyses. Present study showed that evaluation of small bowel mucosa with VCE allows to disclose a potential cause of IDA in near half patients. The cooperation between haematologists and gastroenterologists in the diagnostic work-up may be useful.

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Guarantor of database is Angelo Zullo and data are available upon reasonable request.

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Authors and Affiliations

  1. Gastroenterology Unit, ‘Nuovo Regina Margherita’ Hospital, Rome, Italy

    Angelo Zullo

  2. Gastroenterology Unit, ‘Riuniti’ Hospital, Foggia, Italy

    Vincenzo De Francesco

  3. Gastroenterology Unit, ‘Versilia Hospital’, Lido di Camaiore, Italy

    Luigi Gatta & Federico Corti

  4. Endoscopy Unit., ‘Giovanni Paolo II’ IRCCS, Bari, Italy

    Giuseppe Scaccianoce

  5. Gastroenterology and Endoscopy Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy

    Matteo Colombo, Alessandro Repici, Cesare Hassan & Roberta Elisa Rossi

  6. Digestive Endoscopy Unit, ‘Di Venere’ Hospital, Bari, Italy

    Roberto Bringiotti & Alessandro Azzarone

  7. Haematolgy Unit, ‘Santo Spirito’ Hospital, Rome, Italy

    Angela Rago

  8. Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy

    Alessandro Repici & Cesare Hassan

Authors
  1. Angelo Zullo
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  2. Vincenzo De Francesco
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  3. Luigi Gatta
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  7. Alessandro Azzarone
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  8. Angela Rago
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  9. Federico Corti
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  11. Cesare Hassan
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  12. Roberta Elisa Rossi
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Contributions

Angelo Zullo, Vincenzo De Francesco, Luigi Gatta, and Roberta Elisa Rossi conceived the study, collected data, and analysed the results. Giuseppe Scaccianoce, Matteo Colombo, Roberto Bringiotti, and Alessandro Azzarone performed VCE study and collected data. Angela Rago, Federico Corti, Alessandro Repici, and Cesare Hassan contributed with data interpretation and constructive criticisms. Angelo Zullo and Cesare Hassan wrote the manuscript.

Corresponding author

Correspondence to Angelo Zullo.

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Ethical approval

All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

All patients signed informed consent to underwent videocapsule endoscopy.

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The authors declare no competing interests.

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Zullo, A., De Francesco, V., Gatta, L. et al. Small bowel lesions in patients with iron deficiency anaemia without overt bleeding: a multicentre study. Ann Hematol 103, 1–4 (2024). https://doi.org/10.1007/s00277-023-05450-9

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  • DOI: https://doi.org/10.1007/s00277-023-05450-9

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