Serious gastrointestinal pathology found in patients with serum ferritin values < or = 50 ng/ml.
OBJECTIVE
Our aim was to evaluate the gastrointestinal tract in patients with serum ferritin values < or = 50 ng/ml for the presence of serious gastrointestinal pathology, including neoplasia and acid peptic disease.


METHODS
In this prospective observational study, patients with serum ferritin values < or = 50 ng/ml who did not have an obvious cause of iron deficiency underwent colonoscopy and/or esophagogastroduodenoscopy.


RESULTS
Between October 1, 1994, and February 29, 1996, 725 of 3015 patients who had serum ferritin determinations were found to have values < or = 50 ng/ml. To date, 143 patients have been fully evaluated and 77 were found to have serious gastrointestinal pathology including acid peptic disease (N = 46), cancer (N = 15), and large adenomas (N = 6). Colon cancer was discovered in five asymptomatic patients. The prevalences of serious gastrointestinal pathology did not differ between patients with serum ferritin values < or = 20 ng/ml and those with values between 21-50 ng/ml (63% vs 48%, p = 0.07). However, multivariate analysis showed that the presence of upper or lower gastrointestinal symptoms and serum ferritin value < or = 20 ng/ml is predictive of finding serious pathology (p = 0.0002 for the whole model), with odds ratios of 3.8 (95% confidence interval of 1.84-7.70) for presence of gastrointestinal symptoms and 2.2 (95% confidence interval of 1.09-4.57) for serum ferritin value < or = 20 ng/ml.


CONCLUSIONS
Endoscopic examination is warranted in patients with serum ferritin values < or = 50 ng/ml to detect serious gastrointestinal pathology, present in 54% of such patients.
Lee
J G
JG
Division of Gastroenterology, Portland VAMC, Oregon, USA.
Sahagun
G
G
Oehlke
M A
MA
Lieberman
D A
DA
D000368:Aged; D003110:Colonic Neoplasms / Q000097:blood; D005260:Female; D005293:Ferritins / Q000097:blood*; D005767:Gastrointestinal Diseases / Q000097:blood*; D005770:Gastrointestinal Neoplasms / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010437:Peptic Ulcer / Q000097:blood; D011446:Prospective Studies; D012307:Risk Factors
D005293:Ferritins