Gastrointestinal Disease in Children with Iron Deficiency Anemia

ABSTRACT

PURPOSE: The authors performed this study to find out the associated GI disease and H. pylori infection in children with iron-deficiency anemia(IDA). METHODS: Twenty-six children older than 2 years with IDA and no history of insufficient iron intake were investigated from 1994 to 1998. Gastrofiberoscopic examination and biopsy and rapid urease test were performed with serum H. pylori IgG. Colonofiberoscopic examination and colon study were performed in indicated cases. Combination therapy were used for H. pylori infection. RESULTS: There were 14 males and 12 females, and 69% of total patients were aged 10 to 15 years. GI diseases were revealed in 23 patients. 17 with H. pylori-associated gastroduodenal diseases(8 nodular duodenitis, 7 nodular gastritis, 5 duodenal ulcer, 4 superficial gastritis, 2 gastric ulcer, 1 hemorrhagic duodenitis), 2 with nodular duodenitis, 1 with reflux esophagitis, 1 with duodenal ulcer, 1 with intestinal tuberculosis, and 1 with ulcerative colitis. Of 12 patients with recurrent IDA, 8 had H. pylori-associated gastroduodenal diseases and IDA did not recur after the treatment for H. pylori infection in these 8 patients. The preceeding causes of IDA in 3 with no GI disease were menorrhagia, chronic ITP, and excessive ingestion of raw milk. CONCLUSION: Our results showed that GI diseases should be suspected in children with IDA regardless of abdominal symptoms and H. pylori infection may have an important role in developing IDA. In most children with recurrent IDA, H. pylori-associated gastroduodenal diseases should be considered as well as other preceeding causes of IDA.