Title Anemija u upalnim bolestima crijeva
Title (english) Anemia in inflammatory bowel disease
Author Renata Krulčić
Mentor Brankica Mijandrušić-Sinčić (mentor)
Committee member Sandra Milić (predsjednik povjerenstva)
Committee member Toni Valković (član povjerenstva)
Committee member Sanja Klobučar-Majanović (član povjerenstva)
Granter University of Rijeka Faculty of Medicine (Department of Internal Medicine) Rijeka
Defense date and country 2021-07-16, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Internal Medicine
Abstract Kronične upalne bolesti crijeva su skupina kroničnih, recidivirajućih upalnih poremećaja gastrointestinalnog trakta kojima značajno raste incidencija i prevalencija na globalnoj razini. Njihova najčešća sistemska komplikacija te ekstraintestinalna manifestacija je anemija. Anemija se javlja, ovisno o kriterijima, 4% pa sve do 67% oboljelih od UBC-a te utječe na kvalitetu života oboljelih. Može se javiti bilo koji oblik anemije no najčešća je sideropenična anemija. Druga po učestalosti u sklopu UBC-a, je anemija kronične bolesti koja nastaje kao posljedica složene interakcije citokina i stanica retikuloendotelnog sustava koji utječu na homeostazu željeza te na samu eritropoezu. Po preporukama europskog udruženja za CB i UC, probir na anemiju se radi svim oboljelima svakih 6-12 mjeseci, osim ako su u aktivnoj fazi ili boluju od težeg oblika bolesti, tada se probir radi svaka tri mjeseca. Početni probir radi se na temelju nalaza kompletne krvne slike, serumskog feritina te CRP-a. Za razlikovanje AKB od sideropenične anemije same vrijednosti feritina nisu pouzdane, stoga se u obzir uzimaju i vrijednosti zasićenosti transferina, topljive forme transferinskog receptora te vrijednosti hepcidina. Terapijski izbor za blagu i umjerenu sideropeničnu anemiju je peroralna supstitucija željezom. Ukoliko je riječ o pacijentu koji nema adekvatan odgovor ili ne podnosi preoralnu terapiju ili je teško anemičan (<10 g/dL) tada se željezo daje intravenski. Kod anemije kronične bolesti osnova je optimizirati terapiju osnovne bolesti, što vrlo često izliječi i samu anemiju. Ukoliko nakon optimizacije terapije je anemija i dalje prisutna u obzir dolaze lijekovi koji stimuliraju eritropoezu. Zbog činjenice da se velikom broju pacijenata i nakon terapije anemija ubrzo vrati, nužno je kontrolirati ih laboratorijski svaka tri mjeseca u prvoj godini, a kasnije svakih 6-12 mjeseci.
Abstract (english) Chronic inflammatory bowel disease (CBD) is a group of chronic relapsing inflammatory disorders of gastrointestinal tract, with a rising worldwide incidence and prevalence. Their most common systemic complication and extraintestinal manifestation, is anemia. Anemia occurs, regardless of the criteria, in 4% up to 67% of CBD patients, which significantly affects their quality of life. Any form of anemia can occur but sideropenic anemia is the most common. The second most common within CBD patients, is anemia of chronic diseases that occurs as a result of complex interactions of cytokines and cells of the reticuloendothelial system that affect iron homeostasis and erythropoiesis itself. According to the recommendations of the European Association for CB and UC, screening for anemia is done for all patients every 6-12 months, unless they are in the active phase or suffer from a more severe form of the disease, then screening is done every three months. Initial screening is performed based on the findings of complete blood counts, serum ferritin and CRP. Ferritin values alone are not reliable to distinguish ACD from sideropenic anemia, therefore transferrin saturation values, soluble forms of transferrin receptor, and hepcidin values are also considered. The therapeutic choice for mild and moderate sideropenic anemia is oral iron replacement. If a patient does not have an adequate response or does not tolerate preoral therapy or is severely anemic (<10 g / dL) then iron is given intravenously. In chronic anemia, the basis is to optimize the treatment of the underlying disease, which very often cures the anemia itself. If anemia is still present after optimization of therapy, erythropoiesis-stimulating drugs may be considered. Due to the fact that a large number of patients have a recidive of anemia even after anemia therapy, it is necessary to do the screening for anemia every three months in the first year, and later every 6-12 months.
Keywords
Kronične upalne bolesti crijeva
Crohnova bolest
Ulcerozni kolitis
anemija
anemija zbog manjka željeza
anemija kronične bolesti
nadomjesna terapija željezom
Keywords (english)
Chronic inflammatory bowel disease
Crohn's disease
Ulcerative colitis
anemia
iron deficiency anemia
anemia of chronic disease
iron replacement therapy
Language croatian
URN:NBN urn:nbn:hr:184:466961
Study programme Title: Medicine Study programme type: university Study level: integrated undergraduate and graduate Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2021-07-09 13:56:59