Abnormal Erythropoietin Levels Correlate With Disease Activity in IBD

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Abnormal Erythropoietin Levels Correlate With Disease Activity in IBD

NEW YORK (Reuters Health) Mar 14 - Findings of a study published in the February issue of the Journal of Pediatric Hematology and Oncology suggest a correlation between disturbed erythropoietin levels and disease activity in children and adolescents with inflammatory bowel disease (IBD).

"Iron deficiency anemia (IDA) and anemia of chronic disease (CDA) are often encountered in patients with IBD," Dr. Ioannis Papassotiriou and colleagues from "Aghia Sophia" Children's Hospital in Athens, Greece, write. "Inadequate intake or loss of iron is a clear cause of IDA, but mechanisms of CDA induction are multifactorial and involve erythropoiesis disturbance due to circulating inflammation mediators."

The researchers examined erythropoietin levels in 33 children and adolescents -- median age, 11 years -- with IBD. The subjects were classified as having active disease (n = 21) or disease in remission (n = 12).

"Of the 33 IBD patients, 20 were anemic, 9 of whom were classified as having IDA and 11 as CDA," Dr. Papassotiriou's team explains.

"Seventeen of the 21 patients with active IBD had anemia; 4 were not anemic," they add. The probability of CDA in active IBD "was significantly higher compared with IDA, which was also present in patients with inactive disease."

A total of 16 of the 21 patients with active IBD and four of the 12 with inactive disease had disturbed erythropoietin levels (p < 0.05). Of these 20 patients, 13 were anemic and seven were not.

Fourteen of the patients with affected erythropoietin concentrations had an elevated value compared with the expected value. In these cases, a failure of the bone marrow to respond to increased erythropoietin levels may lead to further incremental response, thus leading to abnormally high levels in the setting of anemia.

Based on these findings, treating the underlying inflammatory bowel disease is the most direct approach to correcting CDA, the investigators advise.

J Pediatr Hematol Oncol 2005;27:93-96.