Data on the effect of Helicobacter pylori (H. pylori) eradication in adult patients with iron-refractory or iron-dependent anaemia, of previously unknown aetiology, are scanty. Consequently, the frequency of H. pylori infection as the cause of anaemia in this scenario is difficult to establish.
In a recent study, Dr Helena Monzón and colleagues state that gastric H. pylori infection is a frequent cause of iron-refractory or iron-dependent anaemia of previously unknown origin in adult patients. In this study the authors reported resolution of iron deficiency anaemia in 32 out of the 84 patients in whom H. pylori had been eradicated (38.1%). In all of these patients there was no relapse after a mean follow-up of 21 ± 2 months. H. pylori infection was considered the aetiology of iron deficiency anaemia in these cases. In addition, the authors discovered that H. pylori infection, as the aetiology of iron deficiency anaemia, was greater in men plus postmenopausal women than in premenopausal women (75.0 vs 23.3%, p<0.0001). Furthermore, the odds ratio of H. pylori infection as the cause of iron deficiency anaemia was almost ten times higher in the first group than the second.
The results of this study show that H. pylori infection is a frequent cause of iron deficiency anaemia in men and postmenopausal women who are either iron refractory or iron dependent, and in whom other causes of iron deficiency anaemia have been previously ruled out. H. pylori eradication therapy produces long-term resolution of iron deficiency anaemia in these patients. H. pylori infection may also be a contributing factor to iron deficiency anaemia in otherwise healthy premenopausal women – it was the aetiology of iron deficiency anaemia in almost 25% of healthy premenopausal women in this study. However, further research is needed to establish this.
The full article is available in the World Journal of Gastroenterology. For further information on how to treat iron deficiency and its related disorders in patients with gastroenterological infections, please visit our ‘Gastroenterology Essentials’ section by clicking here. Video footage of Professor Günter Weiss discussing the relationship between iron and infection can also be found here.