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The course of anaemia in children and adolescents with Crohn's disease included in a prospective registry

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Abstract
Aim: The aim of this study is to determine the prevalence and evolution of anaemia in prospectively followed children and adolescents diagnosed with Crohn's disease (CD). Methods: The BELCRO registry (inclusion May 2008-April 2010), describing current clinical treatment practice of children diagnosed with CD, provided data on age, height, body mass index (BMI), paediatric Crohn's disease activity index (PCDAI), therapy and haemoglobin (Hb) at diagnosis 12 and 24 months follow-up. Anaemia was defined as Hb < -2 sd, while severe anaemia was defined as Hb < -4 sd. Patients were classified as child a parts per thousand currency sign13 and adolescent > 13 years of age. Result: Ninety-six were included, 13 dropped out due to insufficient Hb data (37 females/46 males; median age 13.3 years, range 2.2-17.8 years). At diagnosis, the median Hb sd was -2.66 (-8.4; 1.07) and was correlated with the PCDAI (p = 0.013). At diagnosis, 51/83 (61 %) were anaemic and all had active disease. Hb z-score significantly improved (p < 0.0001) but 26/68 (38 %) remained anaemic at 12 months and 29/76 (38 %) at 24 months of follow-up. The correlation to the PCDAI disappeared. At 24 months, children were more likely to be anaemic. There was no difference in iron dose nor duration of iron supplements between children and adolescents. Iron treatment was more readily given to patients presenting with anaemia. Hb did not differ between patients with (n = 28) or without iron supplements. Half of the patients with persisting anaemia were given iron supplements, of which, only three were given intravenously. Conclusion: Anaemia remains an important extra-intestinal manifestation of CD in children. Physicians, lacking optimal treatment strategies, undertreat their patients.
Keywords
Crohn's disease, Anaemia, Children, Adolescents, INFLAMMATORY-BOWEL-DISEASE, IRON-DEFICIENCY ANEMIA, QUALITY-OF-LIFE, MANAGEMENT, PREVALENCE

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Citation

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Chicago
Van Biervliet, Stephanie, Françoise Smets, Ilse Hofmann, Elisabeth Degreef, Bruno Hauser, Patrick Bontems, Saskia Vande Velde, et al. 2015. “The Course of Anaemia in Children and Adolescents with Crohn’s Disease Included in a Prospective Registry.” International Journal of Colorectal Disease 30 (1): 51–56.
APA
Van Biervliet, Stephanie, Smets, F., Hofmann, I., Degreef, E., Hauser, B., Bontems, P., Vande Velde, S., et al. (2015). The course of anaemia in children and adolescents with Crohn’s disease included in a prospective registry. INTERNATIONAL JOURNAL OF COLORECTAL DISEASE, 30(1), 51–56.
Vancouver
1.
Van Biervliet S, Smets F, Hofmann I, Degreef E, Hauser B, Bontems P, et al. The course of anaemia in children and adolescents with Crohn’s disease included in a prospective registry. INTERNATIONAL JOURNAL OF COLORECTAL DISEASE. 2015;30(1):51–6.
MLA
Van Biervliet, Stephanie, Françoise Smets, Ilse Hofmann, et al. “The Course of Anaemia in Children and Adolescents with Crohn’s Disease Included in a Prospective Registry.” INTERNATIONAL JOURNAL OF COLORECTAL DISEASE 30.1 (2015): 51–56. Print.
@article{5761784,
  abstract     = {Aim: The aim of this study is to determine the prevalence and evolution of anaemia in prospectively followed children and adolescents diagnosed with Crohn's disease (CD). 
Methods: The BELCRO registry (inclusion May 2008-April 2010), describing current clinical treatment practice of children diagnosed with CD, provided data on age, height, body mass index (BMI), paediatric Crohn's disease activity index (PCDAI), therapy and haemoglobin (Hb) at diagnosis 12 and 24 months follow-up. Anaemia was defined as Hb {\textlangle} -2 sd, while severe anaemia was defined as Hb {\textlangle} -4 sd. Patients were classified as child a parts per thousand currency sign13 and adolescent {\textrangle} 13 years of age. 
Result: Ninety-six were included, 13 dropped out due to insufficient Hb data (37 females/46 males; median age 13.3 years, range 2.2-17.8 years). At diagnosis, the median Hb sd was -2.66 (-8.4; 1.07) and was correlated with the PCDAI (p = 0.013). At diagnosis, 51/83 (61 \%) were anaemic and all had active disease. Hb z-score significantly improved (p {\textlangle} 0.0001) but 26/68 (38 \%) remained anaemic at 12 months and 29/76 (38 \%) at 24 months of follow-up. The correlation to the PCDAI disappeared. At 24 months, children were more likely to be anaemic. There was no difference in iron dose nor duration of iron supplements between children and adolescents. Iron treatment was more readily given to patients presenting with anaemia. Hb did not differ between patients with (n = 28) or without iron supplements. Half of the patients with persisting anaemia were given iron supplements, of which, only three were given intravenously. 
Conclusion: Anaemia remains an important extra-intestinal manifestation of CD in children. Physicians, lacking optimal treatment strategies, undertreat their patients.},
  author       = {Van Biervliet, Stephanie and Smets, Fran\c{c}oise and Hofmann, Ilse and Degreef, Elisabeth and  Hauser, Bruno and Bontems, Patrick and Vande Velde, Saskia and Arts, Wim and Paquot, Isabelle and Alliet, Philippe and Bossuyt, Peter and Louis, Edouard and Baert, Filip and Bauraind, Olivia and Rahier, Jean-Fran\c{c}ois and Veereman, Gigi},
  issn         = {0179-1958},
  journal      = {INTERNATIONAL JOURNAL OF COLORECTAL DISEASE},
  language     = {eng},
  number       = {1},
  pages        = {51--56},
  title        = {The course of anaemia in children and adolescents with Crohn's disease included in a prospective registry},
  url          = {http://dx.doi.org/10.1007/s00384-014-2042-4},
  volume       = {30},
  year         = {2015},
}

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