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
