Predictors of gastrointestinal lesions on endoscopy in iron deficiency anemia without gastrointestinal symptoms.
BACKGROUND
Iron deficiency anaemia (IDA) due to occult gastrointestinal (GI) blood loss usually remains unnoticed until patient become symptomatic. There is sparse data in IDA patients without gastrointestinal symptoms. This study was designed to find out the frequency and predictors of endoscopic lesions in IDA without gastrointestinal symptoms. Cross-sectional study performed on a convenience sample of consecutive subjects.


METHODS
Ninety five consecutive patients with laboratory based diagnosis of IDA having no gastrointestinal symptoms were interviewed and their clinical and biochemical variables were recorded. All the study patients underwent esophago-gastroduodenoscopy (EGD) and colonoscopy. Endoscopic findings were documented as presence/absence of bleeding related lesion and presence/absence of cause of IDA. Multiple logistic regressions were performed to identify variables significantly related to outcome variables.


RESULTS
Possible cause of anaemia was found in 71% and bleeding related lesions were found in 53% of patients. Upper gastrointestinal tract lesions were found in 41% of patients with bleeding related lesions. On multivariable logistic regression; advancing age, low mean corpuscular volume (MCV<or=60 fl), and positive fecal occult blood test were predictive factors for bleeding related GI lesions and cause of IDA CONCLUSION: Clinical and Biochemical markers can predict gastrointestinal lesions on endoscopy in IDA patients without gastrointestinal symptoms. High proportion of upper gastrointestinal involvement warrants EGD as initial endoscopic procedure however, this needs validation by further studies.
Majid
Shahid
S
Section of Gastroenterology, Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan. shahid.majid@aku.edu
Salih
Mohammad
M
Wasaya
Rozina
R
Jafri
Wasim
W
D000328:Adult; D000367:Age Factors; D000368:Aged; D018798:Anemia, Iron-Deficiency / Q000209:etiology*; D003430:Cross-Sectional Studies; D016145:Endoscopy, Digestive System; D004909:Erythrocyte Indices; D005260:Female; D005767:Gastrointestinal Diseases / Q000150:complications* / Q000175:diagnosis*; D006471:Gastrointestinal Hemorrhage / Q000150:complications* / Q000175:diagnosis*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009780:Occult Blood; D011237:Predictive Value of Tests