[Effect of Helicobacter pylori eradication on iron deficiency anemia of unknown origin].
Iron deficiency anemia of unknown origin is a frequent cause of anemia in which etiological diagnosis is often not achieved, despite currently available diagnostic techniques. Recent studies suggest that, in the absence of digestive tract lesions, Helicobacter pylori infection could be the cause of iron deficiency anemia, due to the alterations produced in gastric iron absorption.


OBJECTIVE
To evaluate whether H. pylori eradication resolves iron deficiency anemia and removes the need for oral iron administration.


METHODS
We performed an observational descriptive study in patients with iron deficiency anemia refractory to treatment with oral iron administration and with out causes that could explain their anemia. Gastroscopy, ileocolonoscopy, intestinal transit study and/or endoscopic capsule were performed. Female patients also underwent gynecological study. All patients were H. pylori-positive and standard eradication therapy was administered until elimination was achieved. The patients were followed-up for a minimum of 3 months after H. pylori eradication and the need for oral iron intake after eradication was evaluated.


RESULTS
Ten patients, aged 53+/-8.2 years, were included. Hemoglobin (Hbg) before treatment was 10.06+/-0.53 mg/dl, mean corpuscular volume (MCV) was 75.43+/-6.02 fl and ferritin was 6.1+/-3.28 ng/ml. Eradication therapy was administered until elimination of H. pylori. The mean time before disappearance of anemia was 4.5 months. Laboratory parameters after treatment were as follows: Hgb 12.86+/-0.75 mg/dl, MCV 85.02+/-4.8 fl and ferritin 28+/-22.19 ng/dl.


CONCLUSIONS
In the absence of lesions that could explain iron deficiency anemia, this disease can be related to H. pylori infection. Eradication of this infection is closely followed by disappearance of anemia and ferropenia.
Pérez Roldán
Francisco
F
Servicio de Aparato Digestivo, Hospital General La Mancha Centro, Alcázar de San Juan, Ciudad Real, Spain. perezrold@teleline.es
Castellanos Monedero
Jesús Javier
JJ
González Carro
Pedro
P
Villafáñez García
María Concepción
MC
Roncero García-Escribano
Oscar
O
Legaz Huidobro
María Luisa
ML
Ruiz Carrillo
Francisco
F
D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000008:administration & dosage / Q000627:therapeutic use; D018798:Anemia, Iron-Deficiency / Q000188:drug therapy / Q000209:etiology / Q000628:therapy*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000008:administration & dosage / Q000627:therapeutic use; D017291:Clarithromycin / Q000008:administration & dosage / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D016481:Helicobacter Infections / Q000097:blood* / Q000188:drug therapy; D016480:Helicobacter pylori / Q000472:pathogenicity*; D006801:Humans; D007408:Intestinal Absorption; D007501:Iron / Q000493:pharmacokinetics / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000008:administration & dosage / Q000627:therapeutic use; D011446:Prospective Studies; D012074:Remission Induction
D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D000658:Amoxicillin; D007501:Iron; D017291:Clarithromycin; D009853:Omeprazole