Cargando…

Iron Deficiency Is Common after Restorative Proctocolectomy with Ileal Pouch-Anal Anastomosis in Patients with Ulcerative Colitis

BACKGROUND: Micronutrient deficiencies may occur after restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis (IPAA) in patients with ulcerative colitis (UC), largely due to malabsorption and/or pouch inflammation. OBJECTIVES: The objective of this study was to report the frequency of i...

Descripción completa

Detalles Bibliográficos
Autores principales: Dharia, Ishaan, Ahmed, Taqwa, Plietz, Michael, Khaitov, Sergey, Sylla, Patricia, Greenstein, Alexander, Dubinsky, Marla C., Kayal, Maia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: S. Karger AG 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10601944/
https://www.ncbi.nlm.nih.gov/pubmed/37901339
http://dx.doi.org/10.1159/000531580
_version_ 1785126295917559808
author Dharia, Ishaan
Ahmed, Taqwa
Plietz, Michael
Khaitov, Sergey
Sylla, Patricia
Greenstein, Alexander
Dubinsky, Marla C.
Kayal, Maia
author_facet Dharia, Ishaan
Ahmed, Taqwa
Plietz, Michael
Khaitov, Sergey
Sylla, Patricia
Greenstein, Alexander
Dubinsky, Marla C.
Kayal, Maia
author_sort Dharia, Ishaan
collection PubMed
description BACKGROUND: Micronutrient deficiencies may occur after restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis (IPAA) in patients with ulcerative colitis (UC), largely due to malabsorption and/or pouch inflammation. OBJECTIVES: The objective of this study was to report the frequency of iron deficiency in patients with UC who underwent RPC with IPAA and identify associated risk factors. METHODS: We conducted a retrospective chart review of patients with UC or IBD-unclassified who underwent RPC with IPAA at Mount Sinai Hospital between 2008 and 2017. Patients younger than 18 years of age at the time of colectomy were excluded. Descriptive statistics were used to analyze baseline characteristics. Medians with interquartile range (IQR) were reported for continuous variables, and proportions were reported for categorical variables. Iron deficiency was defined by ferritin <30 ng/mL. Logistic regression was used to analyze unadjusted relationships between hypothesized risk factors and the outcome of iron deficiency. RESULTS: A total of 143 patients had iron studies a median of 3.0 (IQR 1.7–5.6) years after final surgical stage, of whom 73 (51.0%) were men. The median age was 33.5 (IQR 22.7–44.3) years. Iron deficiency was diagnosed in 80 (55.9%) patients with a median hemoglobin of 12.4 g/dL (IQR 10.9–13.3), ferritin of 14 ng/mL (IQR 9.0–23.3), and iron value of 44 μg/dL (IQR 26.0–68.8). Of these, 29 (36.3%) had a pouchoscopy performed within 3 months of iron deficiency diagnosis. Pouchitis and cuffitis were separately noted in 4 (13.8%) and 13 (44.8%) patients, respectively, and concomitant pouchitis-cuffitis was noted in 9 (31.0%) patients. Age, sex, anastomosis type, pouch duration, and history of pouchitis and/or cuffitis were not associated with iron deficiency. CONCLUSION: Iron deficiency is common after RPC with IPAA in patients with UC. Cuffitis is seen in the majority of patients with iron deficiency; however, iron deficiency may occur even in the absence of inflammation.
format Online
Article
Text
id pubmed-10601944
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher S. Karger AG
record_format MEDLINE/PubMed
spelling pubmed-106019442023-10-27 Iron Deficiency Is Common after Restorative Proctocolectomy with Ileal Pouch-Anal Anastomosis in Patients with Ulcerative Colitis Dharia, Ishaan Ahmed, Taqwa Plietz, Michael Khaitov, Sergey Sylla, Patricia Greenstein, Alexander Dubinsky, Marla C. Kayal, Maia Inflamm Intest Dis Brief Report BACKGROUND: Micronutrient deficiencies may occur after restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis (IPAA) in patients with ulcerative colitis (UC), largely due to malabsorption and/or pouch inflammation. OBJECTIVES: The objective of this study was to report the frequency of iron deficiency in patients with UC who underwent RPC with IPAA and identify associated risk factors. METHODS: We conducted a retrospective chart review of patients with UC or IBD-unclassified who underwent RPC with IPAA at Mount Sinai Hospital between 2008 and 2017. Patients younger than 18 years of age at the time of colectomy were excluded. Descriptive statistics were used to analyze baseline characteristics. Medians with interquartile range (IQR) were reported for continuous variables, and proportions were reported for categorical variables. Iron deficiency was defined by ferritin <30 ng/mL. Logistic regression was used to analyze unadjusted relationships between hypothesized risk factors and the outcome of iron deficiency. RESULTS: A total of 143 patients had iron studies a median of 3.0 (IQR 1.7–5.6) years after final surgical stage, of whom 73 (51.0%) were men. The median age was 33.5 (IQR 22.7–44.3) years. Iron deficiency was diagnosed in 80 (55.9%) patients with a median hemoglobin of 12.4 g/dL (IQR 10.9–13.3), ferritin of 14 ng/mL (IQR 9.0–23.3), and iron value of 44 μg/dL (IQR 26.0–68.8). Of these, 29 (36.3%) had a pouchoscopy performed within 3 months of iron deficiency diagnosis. Pouchitis and cuffitis were separately noted in 4 (13.8%) and 13 (44.8%) patients, respectively, and concomitant pouchitis-cuffitis was noted in 9 (31.0%) patients. Age, sex, anastomosis type, pouch duration, and history of pouchitis and/or cuffitis were not associated with iron deficiency. CONCLUSION: Iron deficiency is common after RPC with IPAA in patients with UC. Cuffitis is seen in the majority of patients with iron deficiency; however, iron deficiency may occur even in the absence of inflammation. S. Karger AG 2023-07-24 /pmc/articles/PMC10601944/ /pubmed/37901339 http://dx.doi.org/10.1159/000531580 Text en © 2023 The Author(s). Published by S. Karger AG, Basel https://creativecommons.org/licenses/by-nc/4.0/This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission.
spellingShingle Brief Report
Dharia, Ishaan
Ahmed, Taqwa
Plietz, Michael
Khaitov, Sergey
Sylla, Patricia
Greenstein, Alexander
Dubinsky, Marla C.
Kayal, Maia
Iron Deficiency Is Common after Restorative Proctocolectomy with Ileal Pouch-Anal Anastomosis in Patients with Ulcerative Colitis
title Iron Deficiency Is Common after Restorative Proctocolectomy with Ileal Pouch-Anal Anastomosis in Patients with Ulcerative Colitis
title_full Iron Deficiency Is Common after Restorative Proctocolectomy with Ileal Pouch-Anal Anastomosis in Patients with Ulcerative Colitis
title_fullStr Iron Deficiency Is Common after Restorative Proctocolectomy with Ileal Pouch-Anal Anastomosis in Patients with Ulcerative Colitis
title_full_unstemmed Iron Deficiency Is Common after Restorative Proctocolectomy with Ileal Pouch-Anal Anastomosis in Patients with Ulcerative Colitis
title_short Iron Deficiency Is Common after Restorative Proctocolectomy with Ileal Pouch-Anal Anastomosis in Patients with Ulcerative Colitis
title_sort iron deficiency is common after restorative proctocolectomy with ileal pouch-anal anastomosis in patients with ulcerative colitis
topic Brief Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10601944/
https://www.ncbi.nlm.nih.gov/pubmed/37901339
http://dx.doi.org/10.1159/000531580
work_keys_str_mv AT dhariaishaan irondeficiencyiscommonafterrestorativeproctocolectomywithilealpouchanalanastomosisinpatientswithulcerativecolitis
AT ahmedtaqwa irondeficiencyiscommonafterrestorativeproctocolectomywithilealpouchanalanastomosisinpatientswithulcerativecolitis
AT plietzmichael irondeficiencyiscommonafterrestorativeproctocolectomywithilealpouchanalanastomosisinpatientswithulcerativecolitis
AT khaitovsergey irondeficiencyiscommonafterrestorativeproctocolectomywithilealpouchanalanastomosisinpatientswithulcerativecolitis
AT syllapatricia irondeficiencyiscommonafterrestorativeproctocolectomywithilealpouchanalanastomosisinpatientswithulcerativecolitis
AT greensteinalexander irondeficiencyiscommonafterrestorativeproctocolectomywithilealpouchanalanastomosisinpatientswithulcerativecolitis
AT dubinskymarlac irondeficiencyiscommonafterrestorativeproctocolectomywithilealpouchanalanastomosisinpatientswithulcerativecolitis
AT kayalmaia irondeficiencyiscommonafterrestorativeproctocolectomywithilealpouchanalanastomosisinpatientswithulcerativecolitis