Characteristics of Anemia in IBD Patients Based on Duration of Disease and Level of Inflammatory Markers

Purpose: IBD is a unique inflammatory disease process that can cause significant bleed in GI tract, posing a risk for both anemia of chronic disease as well as iron deficiency anemia. The purpose of this study is to identify a significant risk factor which can help distinguish between these two types of anemia. We evaluated the chronicity of disease and level of CRP as possible predictors for anemia of chronic disease. Methods: A total of 70 patients with anemia were enrolled from our IBD clinic. Anemia was defined as a hemoglobin concentration < 13.5 for males and < 12 for females. Anemia was further classified into iron deficiency anemia and anemia of chronic disease. Patients with iron level <60, saturation less than 15% and ferritin less than 20 were classified as iron deficiency anemia. Patients with iron level >60, saturation >15%, and ferritin >20 were classified as anemia of chronic disease. CRP levels were also measured for all patients with anemia and were collected within 3 months of hemogram. Average duration of disease and average CRP were calculated for all patients with anemia. Results: Out of 70 total patients who met criteria for the study, 44 were classified as having iron deficiency anemia (IDA)and 26 patients with anemia of chronic disease (ACD). The average duration of disease in patients with iron deficiency anemia was 10 years as compared to 8 years in patients with anemia of chronic disease (p = 0.2). The average CRP value in patients with iron deficiency anemia was 4.91, compared to 2.83 in patients with anemia of chronic disease (p<0.05). Conclusion: The study shows that patients with higher levels of CRP are more prone to have Iron Deficiency Anemia as compared to anemia of chronic disease. However,there is no significant association between duration of disease and type of anemia in IBD patients.Table: Higher CRP predicts iron deficiency anemia