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Crohn's Disease Forum » Books, Multimedia, Research & News » European Consensus on the Diagnosis and Management of Iron Deficiency and Anaemia in Inflammatory Bowel Diseases


03-01-2015, 02:06 AM   #1
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European Consensus on the Diagnosis and Management of Iron Deficiency and Anaemia in Inflammatory Bowel Diseases

Article:

1. Introduction
Anaemia is the most common systemic complication and extraintestinal manifestation of inflammatory bowel disease [IBD].1–3 In the majority of cases, IBD-associated anaemia is a unique example of the combination of chronic iron deficiency and anaemia of chronic disease [ACD].4,5 Other more rare causes of anaemia in IBD include vitamin B12 and folate deficiency, toxic effects of medications, and others. The impact of anaemia on the quality of life of IBD patients is substantial. It affects various aspects of quality of life such as physical, emotional, and cognitive functions, the ability to work, hospitalization, and healthcare costs.6 Anaemia in IBD is not just a laboratory marker; it is a complication of IBD that needs appropriate diagnostic and therapeutic approaches.

Despite the broad use of anti-inflammatory therapy, anaemia may recur fast after successful therapy. As anaemia is a serious medical condition that may become life threatening [if blood transfusions are not available or compatible], preventive measures should be considered. Prevention of anaemia and maintenance of iron and vitamin stores are therefore warranted.

The goal of this consensus initiated by the European Crohn’s and Colitis Organisation [ECCO] was to establish European consensus guidelines for the diagnosis, treatment and prevention of iron deficiency and iron deficiency anaemia [IDA], but also for non-iron deficiency anaemia and associated conditions.

The consensus is based in parts on a previous evidence-based consensus publication on the diagnosis and management of iron deficiency and anaemia in inflammatory bowel diseases.7 The strategy to reach the consensus involved several steps and follows the standard operating procedures for consensus guidelines of ECCO. An open call for chairs and participants for this consensus was made [see acknowledgements and www.ecco-ibd]. Participants were selected by the Guidelines Committee of ECCO [GuiCom] on the basis of their publication record and a personal statement. Four working groups [WGs] were formed: WG 1 on Diagnosis of anaemia, WG 2 on Treatment of iron deficiency anaemia, WG 3 on Prevention of iron deficiency anaemia, and WG 4 on Management of non-iron deficiency anaemia. Participants were asked to answer relevant questions on current practise and areas of controversy related to the diagnosis and management of anaemia in IBD based on their experience as well as evidence from the literature [Delphi procedure].8 In parallel, the WG members performed a systematic literature search of their topic with the appropriate key words using Medline/PubMed/ISI/Scopus and the Cochrane database, as well as their own files. The evidence level [EL] was graded according to the Oxford Centre for Evidence-Based Medicine.9 Provisional guideline statements [with supporting text] were then written by the WG chairs, based upon answers to the questionnaire, and were circulated among the WG members, prompting discussions and exchange of literature evidence. The proposed statements and the supporting text were submitted to an online platform for online discussion and two online voting procedures, among all consensus participants for the first voting procedure and also for all national representatives of ECCO for the second voting procedure. The WGs finally met in Frankfurt on June 28, 2013 for a face-to-face discussion and to vote and consent on the statements. Technically this was done by projecting the statements and revising them on screen until a consensus was reached. Consensus was defined as agreement by more than 80% of participants, termed a Consensus Statement and numbered for convenience in the document. The final manuscript was written by the WG chairs in conjunction with the WG members and was revised for consistency by CG and AD. An update of this current consensus guideline is planned in about 4 years.
Full Article:

http://ecco-jcc.oxfordjournals.org/content/9/3/211
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Crohn's Disease Forum » Books, Multimedia, Research & News » European Consensus on the Diagnosis and Management of Iron Deficiency and Anaemia in Inflammatory Bowel Diseases
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