title: Helicobacter pylori infection as a cause of iron deficiency anaemia of unknown origin.
abstract: OBJECTIVE
  To assess the aetiological role of Helicobacter pylori (H. pylori) infection in adult patients with iron-refractory or iron-dependent anaemia of previously unknown origin.
  
  
  METHODS
  Consecutive patients with chronic iron-deficient anaemia (IDA) with H. pylori infection and a negative standard work-up were prospectively evaluated. All of them had either iron refractoriness or iron dependency. Response to H. pylori eradication was assessed at 6 and 12 mo from follow-up. H. pylori infection was considered to be the cause of the anaemia when a complete anaemia resolution without iron supplements was observed after eradication.
  
  
  RESULTS
  H. pylori was eradicated in 88 of the 89 patients. In the non-eradicated patient the four eradicating regimens failed. There were violations of protocol in 4 patients, for whom it was not possible to ascertain the cause of the anaemia. Thus, 84 H. pylori eradicated patients (10 men; 74 women) were available to assess the effect of eradication on IDA. H. pylori infection was considered to be the aetiology of IDA in 32 patients (38.1%; 95%CI: 28.4%-48.8%). This was more frequent in men/postmenopausal women than in premenopausal women (75% vs 23.3%; P < 0.0001) with an OR of 9.8 (95%CI: 3.3-29.6). In these patients, anaemia resolution occurred in the first follow-up visit at 6 mo, and no anaemia or iron deficiency relapse was observed after a mean follow-up of 21 ± 2 mo.
  
  
  CONCLUSIONS
  Gastric H. pylori infection is a frequent cause of iron-refractory or iron-dependent anaemia of previously unknown origin in adult patients.
authors.affiliation: Department of Gastroenterology, Hospital Universitari Mútua Terrassa, 08221 Terrassa, Barcelona, Spain.
authors.forename: Helena
authors.initials: H
authors.lastname: Monzón
authors.forename: Montserrat
authors.initials: M
authors.lastname: Forné
authors.forename: Maria
authors.initials: M
authors.lastname: Esteve
authors.forename: Mercé
authors.initials: M
authors.lastname: Rosinach
authors.forename: Carme
authors.initials: C
authors.lastname: Loras
authors.forename: Jorge C
authors.initials: JC
authors.lastname: Espinós
authors.forename: Josep M
authors.initials: JM
authors.lastname: Viver
authors.forename: Antonio
authors.initials: A
authors.lastname: Salas
authors.forename: Fernando
authors.initials: F
authors.lastname: Fernández-Bañares
mesh_terms: D000328:Adult; D000368:Aged; D018798:Anemia, Iron-Deficiency / Q000175:diagnosis / Q000209:etiology*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016009:Chi-Square Distribution; D002908:Chronic Disease; D004359:Drug Therapy, Combination; D005260:Female; D016481:Helicobacter Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D054328:Proton Pump Inhibitors
keywords: Gluten-sensitive enteropathy; Helicobacter pylori; Iron refractoriness; Iron-deficiency anaemia; Menopause