[Pathophysiological-based diagnosis and therapy of iron-deficient anaemia in inflammatory bowel disease]. / Pathophysiologisch-orientierte Diagnostik und Therapie der Eisenmangelanämie bei chronisch entzündlichen Darmerkrankungen.

Anaemia is the most frequent extraenteric complication of inflammatory bowel disease (IBD, Crohn's disease and ulcerative colitis). A disabling complication of IBD, anaemia worsens the patient's general condition and quality of life, and increases hospitalization rates. The main types of anemia in IBD are iron deficiency anemia and anemia of chronic disease. The combination of the serum transferrin receptor with ferritin concentrations and inflammatory markers allows a reliable assessment of the iron status. Iron deficiency is usually treated with oral iron supplements. However, it is less effective in IBD and may lead to an increased inflammatory activity through the generation of reactive oxygen species. A systematic review of anemia in IBD, its pathogenetic features, epidemiology, diagnosis and therapy based on the evidence from recent studies will be the focus of this article.

Diameters of abdominal veins and arteries during nitrate therapy.

The effects of 1.6 mg NTG on the diameter of abdominal veins and arteries were investigated by means of ultrasound tomography in 26 and 28 healthy persons respectively. Fourteen patients served as controls in the venous studies and 28 in the arterial measurements. The diameter of the caval vein decreased in anterior-posterior direction within 5 minutes after nitroglycerin administration by about 22% from 14.2 +/- 4.0 mm to 11.1 +/- 3.3 mm (p less than 0.005). In contrast, the portal vein enlarged by about 27% from 10.3 +/- 1.8 mm to 13.1 +/- 2.3 mm, the superior mesenteric vein by about 12% from 8.2 +/- 1.6 to 9.2 +/- 1.4 mm, and the splenic vein by about 23% from 6.6 +/- 2.3 mm to 8.1 +/- 1.8 mm (p less than 0.001). The superior mesenteric artery and the proper hepatic artery dilated by about 12% from 7.8 +/- 0.9 mm to 8.7 +/- 0.9 mm and from 6.5 +/- 1.0 mm to 7.3 +/- 0.7 mm respectively (p less than 0.001). There was no significant change in the diameter of the abdominal aorta, however. The results show that NTG induces a relaxation of the abdominal veins and of the abdominal arteries of the muscular type. They suggest that the splanchnic veins participate essentially in the therapeutically important venous pooling effect of NTG. The reduced peripheral venous return is made sonographically visible by a collapse of the inferior vena cava. Furthermore, the influence on the windkessel function after administration of NTG seems to be mediated not by the aorta itself, but rather by its large muscular-type branches like the mesenteric and hepatic arteries.