Prevalence of Iron Deficiency and Iron Deficiency Anemia in Pediatric Patients with Inflammatory Bowel Disease: A Systematic Review
Author
Dika, Rami
Term
5. Term (Master thesis)
Education
Publication year
2026
Pages
34
Abstract
Background and aims: Iron-deficiency anemia (IDA) and iron deficiency (ID) are among the most common effects outside the gut (extraintestinal manifestations) in children and adolescents with inflammatory bowel disease (IBD). Reported prevalence varies widely, and the links between anemia, disease activity, and outcomes that matter to patients are not fully defined. We aimed to systematically review the literature to provide an overview of how common IDA and ID are and how they relate to disease activity, quality of life, and growth and development. Methods: We systematically searched major medical databases (PubMed, Embase, Scopus, Cochrane Library, and Web of Science) on October 15, 2025, for studies reporting prevalence or associations. Screening followed PRISMA guidelines (a standard for systematic reviews). Two authors independently selected studies and extracted data, and assessed risk of bias using the Newcastle-Ottawa scale (a tool for judging study quality). Results: Forty-two of 1,067 records met the inclusion criteria. Anemia prevalence ranged from 20-80% depending on diagnostic thresholds, population differences, and sample sizes. Iron deficiency was especially common among those with anemia, often exceeding 70%, and IDA accounted for a substantial share of cases. IDA and ID were generally more frequent in Crohn’s disease than in ulcerative colitis and were consistently associated with higher disease activity, whereas remission was linked to lower prevalence. Limited evidence also suggested a negative impact on quality of life and growth in pediatric patients. Conclusion: IDA and ID are highly prevalent in pediatric IBD and are significantly associated with inflammation and disease activity. Evidence also points to negative effects on quality of life and growth and development, but this remains under-studied. Standardized diagnostic criteria and prospective studies assessing clinical outcomes are needed to clarify the long-term consequences of anemia.
Baggrund og formål: Jernmangelanæmi (IDA) og jernmangel (ID) er blandt de hyppigste symptomer uden for tarmen (ekstraintestinale manifestationer) hos børn og unge med inflammatorisk tarmsygdom (IBD). Alligevel varierer rapporterede forekomsttal meget, og sammenhængen mellem anæmi, sygdomsaktivitet og patientnære resultater er ikke fuldt klarlagt. Formålet var at lave et systematisk review for at give et samlet overblik over forekomsten af IDA og ID og deres forbindelse til sygdomsaktivitet, livskvalitet samt vækst og udvikling. Metoder: Vi søgte systematisk i store medicinske databaser (PubMed, Embase, Scopus, Cochrane Library og Web of Science) den 15. oktober 2025 efter studier med prævalenstal eller associationsmål. Udvælgelse fulgte PRISMA-retningslinjerne (en standard for systematiske reviews). To forfattere udvalgte uafhængigt studier og udtrak data samt vurderede risiko for bias med Newcastle-Ottawa-skalaen (et værktøj til at bedømme studiekvalitet). Resultater: 42 af 1.067 identificerede studier opfyldte inklusionskriterierne. Anæmiforekomsten varierede fra 20-80% afhængigt af diagnostiske grænseværdier, forskelle i populationer og størrelsen på studierne. Jernmangel var især udbredt blandt patienter med anæmi og oversteg ofte 70%, og IDA udgjorde en betydelig andel af tilfældene. IDA og ID sås generelt oftere ved Crohns sygdom end ved colitis ulcerosa og var konsekvent forbundet med højere sygdomsaktivitet, mens remission var koblet til lavere forekomst. Begrænset evidens tydede også på en negativ påvirkning af livskvalitet og vækst hos børn. Konklusion: IDA og ID er meget udbredte blandt pædiatriske IBD-patienter og er signifikant forbundet med inflammation og sygdomsaktivitet. Evidens peger også på negative konsekvenser for livskvalitet, vækst og udvikling, men dette er utilstrækkeligt undersøgt. Der er behov for standardiserede diagnostiske kriterier og prospektive studier, der vurderer kliniske udfald, for at afklare de langsigtede konsekvenser af anæmi.
[This apstract has been rewritten with the help of AI based on the project's original abstract]