Gastropathic sideropenia

Chaim Hershko*, Amnon Lahad, Dan Kereth

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

23 Scopus citations

Abstract

There has been an increasing awareness recently of subtle, non-bleeding gastrointestinal conditions that may result in abnormal iron absorption leading to iron-deficiency anaemia (IDA) in the absence of gastrointestinal symptoms. Thus, the importance of coeliac disease as a possible cause of IDA refractory to oral iron treatment, without other manifestations of malabsorption syndrome, is increasingly being recognized. In addition, Helicobacter pylori has been implicated in several recent studies as a cause of IDA refractory to oral iron treatment, and the anaemia responds favourably to H. pylori eradication. Likewise, achlorhydric gastric atrophy or atrophic body gastritis (ABG), a condition associated with chronic idiopathic iron deficiency, has been shown to be responsible for refractory IDA in over 20% of patients with no evidence of gastrointestinal blood loss. It has also been suggested that H. pylori gastritis may represent an early phase of ABG in which infection may trigger an autoimmune process directed against gastric parietal cells by means of antigenic mimicry. In this review we examine in a critical manner the role of H. pylori gastritis in the causation of IDA, the role of ABG in the pathogenesis of iron malabsorption, the evidence supporting a possible cause-and-effect relationship between H. pylori gastritis and ABG, and the implications of these findings for the diagnostic work-up and management of IDA.

Original languageAmerican English
Pages (from-to)363-380
Number of pages18
JournalBest Practice and Research: Clinical Haematology
Volume18
Issue number2 SPEC. ISS.
DOIs
StatePublished - Jun 2005

Keywords

  • Achlorhydria
  • Achylia gastrica
  • Antiendomysial antibodies
  • Antiparietal cell antibodies
  • Atrophic body gastritis (ABG)
  • Coeliac disease
  • Duodenal ulcer (DU)
  • Gastrin
  • Gastrointestinal (GI)
  • Gastropathic sideropenia
  • Helicobacter pylori (H. pylori)
  • Intrinsic factor
  • Iron-deficiency anaemia (IDA)
  • Pernicious anaemia

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