Evaluation of anemia at diagnosis and during follow-up in childhood inflammatory bowel diseases.

The aim of this study is to evaluate anemia in children with inflammatory bowel diseases (IBD), both at the time of diagnosis and over a 1-year follow-up period. A total of 160 children with IBD were included in this retrospective study. Demographic, clinical characteristics, laboratory parameters, and treatment modalities were evaluated. Etiologies of anemia were determined. The mean age of the patients was 154.9 ± 39.6 months and M/F:1.1. Then, 61.9% of the patients at diagnosis and 25.9% at follow-up had anemia. The most common cause of anemia was iron defiency anemia (IDA) at diagnosis and follow-up (58.7% vs. 25.9%). Further, 80.6% of the patients had iron deficiency which decreased to 71.6% at follow-up. Anemia of chronic disease was determined in 54.4% of the patients at diagnosis, and in 12.9% at follow-up. Vitamin B12 deficiency was observed in 21.3% of the patients and vitamin B12 anemia in 11.9% of those patients at diagnosis, but these rates decreased to 9.5% and 1.7%, respectively during follow-up. Folic acid deficiency was 13.8% and folic acid anemia was 8.8% at diagnosis, but these rates decreased to 4.3% and 1.7%, respectively during follow-up. Anemia was more common in patients with moderate and severe disease than those with mild disease.

conclusionAnemia is highly prevalent in pediatric IBD, particularly at diagnosis, and may persist despite treatment in a considerable number of patients. Regular screening and etiology-specific management are essential for optimizing growth and long-term outcomes. Prospective multicenter studies are needed to establish standardized anemia monitoring and treatment protocols in pediatric IBD. WHAT IS KNOWN: • Anemia is one of the most common extraintestinal manifestations in inflammatory bowel disease (IBD). • The most common type of anemia in patients with IBD are iron deficiency anemia and anemia of chronic disease. WHAT IS NEW: • This is one of the few pediatric IBD studies to longitudinally evaluate anemia subtypes (iron deficiency, anemia of chronic disease, vitamin B12, and folate) at both diagnosis and 1-year follow-up. • We show that more than half of patients had mixed anemia etiologies at diagnosis, highlighting the multifactorial pathophysiology of anemia in IBD. One-third of children remained anemic after 1 year, despite treatment, underscoring the need for standardized monitoring and tailored interventions in pediatric IBD care.