Serious gastrointestinal pathology found in patients with serum ferritin values ≤ 50 ng/ml

John G. Lee, Geronimo Sahagun, Megan A. Oehlke, David Lieberman

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Objective: Our aim was to evaluate the gastrointestinal tract in patients with serum ferritin values ≤50 ng/ml for the presence of serious gastrointestinal pathology, including neoplasia and acid peptic disease. Methods: In this prospective observational study, patients with serum ferritin values ≤ 50 ng/ml who did not have an obvious cause of iron deficiency underwent colonoscopy and/or esophagogastroduodenoscopy. Results: Between October 1, 1994, and February 29, 1996, 725 of 3015 patients who had serum ferritin determinations were found to have values ≤ 50 ng/ml. To date, 143 patients have been fully evaluated and 77 were found to have serious gastrointestinal pathology including acid peptic disease (N = 46), cancer (N = 15), and large adenomas (N = 6). Colon cancer was discovered in five asymptomatic patients. The prevalences of serious gastrointestinal pathology did not differ between patients with serum ferritin values ≤ 20 ng/ml and those with values between 21-50 ng/ml (63% vs 48%, p = 0.07). However, multivariate analysis showed that the presence of upper or lower gastrointestinal symptoms and serum ferritin value ≤20 ng/ml is predictive of finding serious pathology (p = 0.0002 for the whole model), with odds ratios of 3.8 (95% confidence interval of 1.84-7.70) for presence of gastrointestinal symptoms and 2.2 (95% confidence interval of 1.09-4.57) for serum ferritin value ≤ 20 ng/ml. Conclusions: Endoscopic examination is warranted in patients with serum ferritin values ≤ 50 ng/ml to detect serious gastrointestinal pathology, present in 54% of such patients.

Original languageEnglish (US)
Pages (from-to)772-776
Number of pages5
JournalAmerican Journal of Gastroenterology
Volume93
Issue number5
DOIs
StatePublished - May 1998
Externally publishedYes

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Ferritins
Pathology
Serum
Digestion
Confidence Intervals
Digestive System Endoscopy
Acids
Colonoscopy
Adenoma
Colonic Neoplasms
Observational Studies
Gastrointestinal Tract
Neoplasms
Multivariate Analysis
Iron
Odds Ratio
Prospective Studies

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Serious gastrointestinal pathology found in patients with serum ferritin values ≤ 50 ng/ml. / Lee, John G.; Sahagun, Geronimo; Oehlke, Megan A.; Lieberman, David.

In: American Journal of Gastroenterology, Vol. 93, No. 5, 05.1998, p. 772-776.

Research output: Contribution to journalArticle

Lee, John G. ; Sahagun, Geronimo ; Oehlke, Megan A. ; Lieberman, David. / Serious gastrointestinal pathology found in patients with serum ferritin values ≤ 50 ng/ml. In: American Journal of Gastroenterology. 1998 ; Vol. 93, No. 5. pp. 772-776.
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abstract = "Objective: Our aim was to evaluate the gastrointestinal tract in patients with serum ferritin values ≤50 ng/ml for the presence of serious gastrointestinal pathology, including neoplasia and acid peptic disease. Methods: In this prospective observational study, patients with serum ferritin values ≤ 50 ng/ml who did not have an obvious cause of iron deficiency underwent colonoscopy and/or esophagogastroduodenoscopy. Results: Between October 1, 1994, and February 29, 1996, 725 of 3015 patients who had serum ferritin determinations were found to have values ≤ 50 ng/ml. To date, 143 patients have been fully evaluated and 77 were found to have serious gastrointestinal pathology including acid peptic disease (N = 46), cancer (N = 15), and large adenomas (N = 6). Colon cancer was discovered in five asymptomatic patients. The prevalences of serious gastrointestinal pathology did not differ between patients with serum ferritin values ≤ 20 ng/ml and those with values between 21-50 ng/ml (63{\%} vs 48{\%}, p = 0.07). However, multivariate analysis showed that the presence of upper or lower gastrointestinal symptoms and serum ferritin value ≤20 ng/ml is predictive of finding serious pathology (p = 0.0002 for the whole model), with odds ratios of 3.8 (95{\%} confidence interval of 1.84-7.70) for presence of gastrointestinal symptoms and 2.2 (95{\%} confidence interval of 1.09-4.57) for serum ferritin value ≤ 20 ng/ml. Conclusions: Endoscopic examination is warranted in patients with serum ferritin values ≤ 50 ng/ml to detect serious gastrointestinal pathology, present in 54{\%} of such patients.",
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