title: A prospective evaluation of adult men with iron-deficiency anemia in Korea.
abstract: OBJECTIVE
  Iron-deficiency anemia (IDA) is the most common nutritional deficiency worldwide. However, the information concerning various causes of IDA in adult men is still insufficient. The aim of our study was to evaluate adult men with IDA.
  
  
  METHODS
  We prospectively studied 206 adult men with IDA. All subjects had a direct history taken and underwent a physical examination. Esophagogastroduodenoscopy was performed in most patients, and colonoscopy was conducted if no lesion causing IDA was found or the fecal occult blood test was positive.
  
  
  RESULTS
  The history of prior gastrectomy and blood-letting cupping therapy that probably had caused IDA were reported in 24 (11.7%) and 11 (5.3%) patients, respectively. In terms of potential causes of IDA, 68 (33.0%) patients were found to have upper gastrointestinal disorders (34 peptic ulcers, 17 erosive gastritis, 16 gastric cancers, and one gastrointestinal stromal tumor). Colonoscopy showed 42 (20.4%) clinically relevant lesions that probably caused IDA: colon cancer (five patients), colon polyps (14 patients), ulcerative colitis (one patient), and hemorrhoids (22 patients). One small bowel tumor was detected at small bowel series. Concerning malignant lesions that were responsible for IDA, 22 malignant lesions were found in patients of 50 years or older, accounting for 16.8% (22 of 131 patients), while only one (1.3%) early gastric cancer was found in the younger patients.
  
  
  CONCLUSIONS
  This study demonstrated that gastrointestinal blood loss is the main cause of IDA in adult men, and that there is a high rate of malignancy in men older than 50 years, emphasizing the need for a complete, rigorous gastrointestinal examination in this group of patients. Considering blood-letting cupping therapy, there is a need to consider culture-specific procedures as a possible cause of IDA.
authors: Department of Internal Medicine, Chungnam National University School of Medicine, Korea.
authors: Gak Won
authors: GW
authors: Yun
authors: Young Joon
authors: YJ
authors: Yang
authors: Ik Chan
authors: IC
authors: Song
authors: Keon Uk
authors: KU
authors: Park
authors: Seung-Woo
authors: SW
authors: Baek
authors: Hwan Jung
authors: HJ
authors: Yun
authors: Samyong
authors: S
authors: Kim
authors: Deog Yeon
authors: DY
authors: Jo
authors: Hyo Jin
authors: HJ
authors: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018798:Anemia, Iron-Deficiency / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D005767:Gastrointestinal Diseases / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult