Can asymptomatic Chron’s disease be diagnosed in patients with iron deficiency anemia by CT-enterograhpy?

Yıl 2021, Cilt: 38 Sayı: 2s, 71 - 73, 18.03.2021

Ufuk Avcıoğlu Ayşegül İdil Soylu

Öz

It is difficult to diagnose Crohn's disease in the asymptomatic period. The aim of this study is to evaluate the diagnostic utility of CT enterography (CTE) in the diagnosis of asymptomatic Crohn's disease (CD) with small intestine involment in patients with iron deficiency anemia (IDA).

250 patients who underwent CTE examination between 2017 and 2018 were retrospectively scanned. 45 patients who had endoscopic examinations and diagnosed with IDA were included in the study.
While one or more pathological findings to explain IDA were observed in 31 (68%) patients with endoscopic examinations, findings that could be explained as CD sequelae were observed in 4 (8.8%) patients. No lesions were observed by CTE in 10 (22.2%) patients.

Diagnosis is difficult in mild forms of Crohn’s disease or in periods of remission. In this
period, CTE can contribute to the diagnosis as it can also show extraluminal findings.

Anahtar Kelimeler

Crohn's disease, iron deficiency anemia, CT enterography

Kaynakça

• Berther R, Patak MA, Eckhardt B, Erturk SM, Zollikofer CL., 2008. Comparison of neutral oral contrast versus positive oral contrast medium in abdominal multidetector CT. Eur Radiol., 18(9):1902-1909
• Beutler E, Waalen J., 2006. The definition of anemia: what is the lower limit of normal of the blood hemoglobin concentration? Blood, 107:1747-50.
• Bodily KD, Fletcher JG, Solem CA, Johnson CD, Fidler JL, Barlow JM, Bruesewitz MR, McCollough CH, Sandborn WJ, Loftus Jr EV, Harmsen WS, Crownhart BS., 2006. Crohn disease: mural attenuation and thickness at contrastenhanced CT enterography—correlation with endoscopic and histologic findings of inflammation. Radiology, 238:505–516
• Booya F, Fletcher JG, Huprich JE, Barlow, JM, Johnson CD, Fidler JL, Solem CA, Sandborn WJ, Loftus Jr EV, Harmsen WS, 2006. Active Crohn Disease: CT Findings and Interobserver Agreement for Enteric Phase CT Enterography. Radiology, 241:787
• Bruining DH, Loftus EV., 2006. Evolving diagnostic strategies for inflammatory bowel disease. Curr Gastroenterol Rep., 8:478.
• Farmer RG, Whelan G, Fazio VW., 1985. Long-term follow-up of patients with Crohn’s disease. Relationship between the clinical pattern and prognosis. Gastroenterology, 88:1818
• Hardwick RH, Armstrong CP., 1997. Synchronous upper and lower gastrointestinal endoscopy is an effective method of investigating iron-deficiency anemia. Br J Surg., 84:1725-8.
• Looker AC, Dalman PR, Carroll MD, Gunter EW, Johnson CL., 1997. Prevalance of iron deficiency anemia in United States. JAMA, 277:973-6.
• Macari M, Megibow Aj, Balthazar Ej., 2007. A pattern approach to the abnormal small bowel: Observations at MDCT and CT enterography. AJR Am J Roentgenol., 188:1344-1355
• Maglinte DDT, Sandrasegaran K, Tann M., 2006. Advances in alimentary tract imaging. World J Gastroenterol., 12(20):3139-3145
• Provan D., 1999. Mechanism and management of iron deficiency anemia. Br J Haematol., 105(Suppl 1):19-26.
• Satsangi J, Silverberg MS, Vermeire S, Colombel JF., 2006. The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications. Gut, 55:749.
• Siddiki HA, Fidler JL, Fletcher JG, et al., 2009. Prospective comparison of state-of-the-art MR enterography and CT enterography in small-bowel Crohn's disease. AJR Am J Roentgenol., 193:113.
• Solberg IC, Vatn MH, Høie O, et al., 2007. Clinical course in Crohn's disease: results of a Norwegian population-based ten-year follow-up study. Clin Gastroenterol Hepatol., 5:1430.