Dramatic and prompt efficacy of Helicobacter pylori eradication in the treatment of severe refractory iron deficiency anemia in adults.
Dramatic and prompt efficacy of Helicobacter pylori eradication in the treatment of severe refractory iron deficiency anemia in adults.
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根除幽门螺杆菌在治疗成人严重难治性缺铁性贫血中具有显着而迅速的疗效。
DOI：
10.1007/s00277-014-2052-x
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发表时间：
2014
期刊：
影响因子：
3.5
通讯作者：
Yasukawa M
中科院分区：
文献类型：
--
作者：
Yamanouchi J;Azuma T;Yakushijin Y;Hato T;Yasukawa M
亲爱的编辑：缺铁性贫血(IDA)是全球最常见的营养性疾病之一。缺铁性贫血的基本治疗方法是口服铁质药物；然而，一些缺铁性贫血患者偶尔对这种疗法无效[1]。最近，幽门螺杆菌在IDA病因学中的作用已成为一个相当感兴趣的焦点[2，3]。尽管幽门螺杆菌与缺铁性贫血的关系已经被广泛研究，但大多数研究都集中在学龄儿童和年轻人中的轻度缺铁性贫血[4-6]。在这里，我们报告两例严重缺铁性贫血的成人病例，经根除幽门螺杆菌治疗后，贫血得到显著而迅速的改善(图1)。病例1，73岁男性，因严重贫血而到本院就诊。他已经接受口服铁(100毫克/天)治疗6个多月，但他的贫血没有明显改善。实验室检查显示严重缺铁性贫血(红细胞269×10~10/L，血红蛋白4.7g/dl，红细胞压积17.5%，平均红细胞体积65.1fl，平均红细胞血红蛋白浓度17.5pg，血清铁8μg/dl，血清铁蛋白4.7 ng/ml，不饱和铁结合量487μg/dl)。上、下胃肠道内窥镜检查发现轻度萎缩性胃炎合并幽门螺杆菌感染，但胃肠道任何部位均未发现出血。大便潜血测试结果为阴性。CT检查也未发现异常。因为口服铁剂治疗在这方面失败了
Dear Editor, Iron deficiency anemia (IDA) is one of the most common nutritional diseases worldwide. The basic treatment for IDA is oral iron medication; however, some patients with IDA are occasionally refractory to this type of therapy [1]. Recently, the role of Helicobacter pylori in the etiology of IDA has become a focus of considerable interest [2, 3]. Although the association of H. pylori with IDA has been examined extensively, most studies have focused on mild IDA in school-aged children and young people [4–6]. Here, we report two adult cases of severe IDA refractory to oral iron therapy in which the anemia was dramatically and promptly improved by H. pylori eradication (Fig. 1).Case 1 A 73-year-old male was referred to our hospital because of severe anemia. He had been receiving oral iron (100 mg/day) therapy for more than 6 months, but his anemia had not improved significantly. Laboratory examinations revealed severe IDA (red blood cell count 269× 1010/l, hemoglobin 4.7 g/dl, hematocrit 17.5%, mean corpuscular volume 65.1 fl, mean corpuscular hemoglobin concentration 17.5 pg, serum iron 8 μg/dl, serum ferritin 4.7 ng/ml, unsaturated iron binding capacity 487 μg/dl). Endoscopic examination of the upper and lower gastrointestinal (GI) tract revealed mild atrophic gastritis with H. pylori infection, but no bleeding was detected in any part of the GI tract. A stool occult blood test gave a negative result. CT examination also revealed no abnormalities. Because oral iron therapy had failed in this