CLINICAL SIGNIFICANCE OF C-REACTIVE PROTEIN LEVELS IN PREDICTING RESPONSIVENESS TO IRON THERAPY IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE AND IRON DEFICIENCY ANEMIA

Authors

  • Andreea-Georgiana OTEA “Grigore T. Popa” University of Medicine and Pharmacy Iasi, Romania
  • Raluca Cezara POPA “Sf. Spiridon” County Clinical Emergency Hospital Iasi
  • Iolanda Valentina POPA “Grigore T. Popa” University of Medicine and Pharmacy Iasi, Romania
  • I.P. BEJINARIU “Sf. Spiridon” County Clinical Emergency Hospital Iasi
  • Anca CARDONEANU “Grigore T. Popa” University of Medicine and Pharmacy Iasi, Romania
  • Otilia GAVRILESCU “Grigore T. Popa” University of Medicine and Pharmacy Iasi, Romania
  • Mihaela DRANGA “Grigore T. Popa” University of Medicine and Pharmacy Iasi, Romania
  • Cristina CIJEVSCHI PRELIPCEAN “Sf. Spiridon” County Clinical Emergency Hospital Iasi
  • Catalina MIHAI “Grigore T. Popa” University of Medicine and Pharmacy Iasi, Romania

Abstract

CLINICAL SIGNIFICANCE OF C-REACTIVE PROTEIN LEVELS IN PREDICTING RESPONSIVENESS TO IRON THERAPY IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE AND IRON DEFICIENCY ANEMIA (Abstract): Iron deficiency anemia (IDA) has been recognized as a major cause of anemia in inflammatory bowel disease (IBD). Anemia has a significant impact on the quality of life of these patients and thus correction is very important. Aim: To determine if systemic inflammation (assessed by C-reactive protein [CRP]) can predict the response to iron therapy (oral versus intravenous). Material and methods: A seven-month prospective study (June-December 2016) conducted at the Iasi Institute of Gastroenterology and Hepatology. Sixty-three patients with IBD and IDA were assessed. Inflammation was defined as CRP levels > 4mg/L. Patients were divided as follows: 29 patients received iron based oral treatment (group A) and 34 intravenous therapy [IV] (group B). Results: Of the 29 group A patients 14 responded (11 had CRP levels < 4mg/L and 3 CRP levels > 4mg/L) and 15 did not respond (3 with CRP levels < 4mg/L and 12 with CRP levels > 4mg/L). As to the 35 group B patients, 25 responded (12 with CRP levels < 4mg/L and 13 with CRP levels > 4mg/L) and 9 did not respond (4 with CRP levels < 4mg/L and 5 with CRP levels > 4mg/L). Among iron tablet-treated patients, hemoglobin (Hb) increase was significantly slower in the high versus low CRP subgroup (2.8 vs 3.8 g/dL, p=0.04). Response to IV therapy was independent of inflammation. Conclusions: Patients with higher CRP levels achieved a lower Hb response with oral iron therapy. CRP may be useful in selecting the iron administration route as well as identifying IBD patients who can benefit from first-line IV iron therapy to improve their IDA.

Author Biographies

  • Andreea-Georgiana OTEA, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, Romania

    Faculty of Medicine
    Department of Medical Specialties (I)
    “Sf. Spiridon” County Clinical Emergency Hospital Iasi
    Institute of Gastroenterology and Hepatology

  • Raluca Cezara POPA, “Sf. Spiridon” County Clinical Emergency Hospital Iasi

    Institute of Gastroenterology and Hepatology

  • Iolanda Valentina POPA, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, Romania

    Faculty of Medicine
    Department of Medical Specialties (I)
    “Sf. Spiridon” County Clinical Emergency Hospital Iasi
    Institute of Gastroenterology and Hepatology

  • I.P. BEJINARIU, “Sf. Spiridon” County Clinical Emergency Hospital Iasi

    Institute of Gastroenterology and Hepatology

  • Anca CARDONEANU, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, Romania

    Faculty of Medicine
    Department of Medical Specialties (I)
    Clinical Rehabilitation Hospital, Iasi

  • Otilia GAVRILESCU, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, Romania

    Faculty of Medicine
    Department of Medical Specialties (I)
    “Sf. Spiridon” County Clinical Emergency Hospital Iasi
    Institute of Gastroenterology and Hepatology

  • Mihaela DRANGA, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, Romania

    Faculty of Medicine
    Department of Medical Specialties (I)
    “Sf. Spiridon” County Clinical Emergency Hospital Iasi
    Institute of Gastroenterology and Hepatology

  • Cristina CIJEVSCHI PRELIPCEAN, “Sf. Spiridon” County Clinical Emergency Hospital Iasi

    Institute of Gastroenterology and Hepatology

  • Catalina MIHAI, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, Romania

    Faculty of Medicine
    Department of Medical Specialties (I)
    “Sf. Spiridon” County Clinical Emergency Hospital Iasi
    Institute of Gastroenterology and Hepatology

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Additional Files

Published

2019-03-29

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Section

INTERNAL MEDICINE - PEDIATRICS