Abstract
Purpose: Iron deficiency anemia is often attributed to menstrual blood loss in premenopausal
women. The aims of this study were to determine the diagnostic yield of endoscopy
and to evaluate the clinical outcome in these women.
Methods: Charts, endoscopy records, and pathology reports were reviewed in consecutive
premenopausal women with documented iron deficiency anemia who were referred for diagnostic
endoscopy. Follow-up was obtained by telephone contact and review of medical records.
Results: Endoscopy revealed a clinically important lesion in 23 (12%) of 186 patients.
An upper gastrointestinal source was identified in 12 patients, most commonly due
to gastric cancer (3%) or peptic ulcer disease (3%). A colonic lesion was detected
in 11 patients, with colon cancer in six (3%). No patient had a lesion identified
in both the upper and lower gastrointestinal tract. Small bowel biopsies and radiography
were normal in all patients in whom they were obtained. Independent predictors for
having a gastrointestinal lesion identified by endoscopy include a positive fecal
occult blood test, a hemoglobin of <10 g/dL, and abdominal symptoms. Long-term follow-up
data suggested a favorable prognosis, and iron deficiency anemia resolved with appropriate
therapy in nearly all patients.
Conclusions: Endoscopy yields important findings in premenopausal women with iron
deficiency anemia, which should not be attributed solely to menstrual blood loss.
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Article info
Publication history
Published online: August 16, 2004
Accepted:
May 19,
1998
Received in revised form:
May 19,
1998
Received:
January 6,
1998
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© 1998 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
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