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DOI: 10.1055/s-0045-1806149
Iron Deficiency Anemia: Role of Upper Digestive Endoscopy and Histopathology in Etiological Diagnosis
Aims Iron deficiency anemia is a common reason for consultation in gastroenterology. Its frequency, even in the absence of digestive symptoms, often necessitates exploration through upper digestive endoscopy. The aim of this study is to assess the relevance of esophagogastroduodenoscopy (EGD) and histopathology in the etiological diagnosis of iron deficiency anemia
Methods This is a monocentric, descriptive, retrospective study conducted over a period of one and a half year (December 2021 – May 2024), which included all patients who consulted our department for iron deficiency anemia and underwent an EGD
Results In our series, 150 patients were included, with an average age at the time of exploration of 52.1 years (range 17–81 years) and a sex ratio of 0.7, consisting of 62 men (41%) and 88 women (59%). In this cohort, 5% of EGDs were strictly normal.The group of patients with abnormal EGDs (n=142) was studied separately, with the most common findings observed: 8% had esophagitis, 28% had congestive fundic gastropathy (3% nodular), 34% had congestive antral gastritis (6% nodular), and 7% and 5% had ulcerative or erosive bulbitis, respectively. A reduction in the height of duodenal folds was observed in 6% of patients.Of the total cohort, 81% (n=122) underwent duodenal biopsies, showing normal histology in 88% of cases, villous atrophy with intraepithelial lymphocytosis suggestive of celiac disease in 9% of cases, and nonspecific duodenitis in 3% of patients. Sixty-five percent (n=98) underwent gastric biopsies, which revealed chronic gastritis due to Helicobacter pylori (HP) in 71% of cases, atrophic gastritis in 11%, and intestinal metaplasia in 18%
Conclusions Upper digestive endoscopy combined with gastroduodenal biopsies is an effective diagnostic tool for evaluating the etiology of iron deficiency anemia, with a predominance of Helicobacter pylori-related gastritis and celiac disease in our setting
Conflicts of Interest
Authors do not have any conflict of interest to disclose.
Publication History
Article published online:
27 March 2025
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