Identification and Diagnosis

Hepcidin may differentiate between types of anaemia, which may lead to varied therapeutic strategies, according to new research. Authors suggest that hepcidin may be more effective as a diagnostic marker of anaemia in cancer patients than serum iron, total iron-binding capacity (TIBC), or transferrin saturation (TSAT). They state that hepcidin could be used as a serological marker in the differential diagnosis of tumour-related anaemia of chronic disease (ACD) and iron deficiency anaemia.

New data reveals an increased risk of iron deficiency and iron deficiency anaemia in premenopausal women who are of Asian ethnicity, regularly donate blood and who have a previous history of iron deficiency. The analysis also indicates that dietary patterns have a smaller, but still substantial, effect on the risk of developing the condition.

Professor Michael Auerbach is a haematologist and oncologist at Auerbach Hematology and Oncology Associates, Inc. (Baltimore, USA) and a Clinical Professor of Medicine at Georgetown University School of Medicine (Washington DC). He is also a member of the Lombardi Cancer Center (Washington DC). He serves on the scientific board of the Network for Advancement of Transfusion Alternatives, and advises the Society for the Advancement of Blood Management.

A new article has indicated that both iron deficiency and anaemia are prevalent in patients with Crohn’s disease and ulcerative colitis, with a higher prevalence in the former. The authors also demonstrate that more than half of anaemic patients with inflammatory bowel disease have iron deficiency.

A survey in patients treated for chemotherapy-induced anaemia (CIA) indicates that management of anaemia and assessment of iron status varies substantially across Europe and that iron therapy is frequently under-utilised.

Patients with cancer frequently experience CIA and iron deficiency. This study evaluated routine practice in CIA management. Medical oncologists and haematologists from nine European countries (n=375) were surveyed on their last five cancer patients treated for CIA (n=1,730).

This year’s European Crohn’s and Colitis Organisation congress (ECCO) took place on the 20–22 February 2014 in Copenhagen, Denmark. The congress saw record attendance with a total of 5175 delegates from 78 countries. Sessions relating to iron deficiency in gastroenterology included details on emerging iron therapies for inflammatory bowel disease, biomarkers of iron absorption and iron deficiency, updates to ECCO guidelines and recent prevalence data for iron deficiency. Presented below are some of the highlights.

Recent research has ascertained that, although iron deficiency is common in patients with chronic obstructive pulmonary disease (COPD), it is not routinely tested for or treated. It has also been shown that treating these patients with erythropoietin stimulating agents (ESAs) or intravenous iron not only corrects the iron deficiency but also improves symptoms of dyspnoea.

Laparoscopic Roux-en-Y gastric bypass (LRYGB) is the most widely used procedure for the surgical treatment of obesity in the USA.  Reduced iron absorption is an expected consequence of this surgical intervention due to exclusion of the duodenum and proximal jejunum resulting in reduced iron absorption, diminished exposure of food to gastric acidity and reduced dietary intake1.

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