Oxidative Stress after Iron Supplementation in Crohn's Disease Marcia Morandi Varela Junqueira-Franco, Carolina Ferreira Nicoletti, Carla Barbosa Nonino, Hélio Vannucchi and Julio Sergio Marchini * Internal Medicine Department, University of São Paulo, Brazil * Corresponding author: Julio Sergio Marchini, Internal Medicine Department, University of São Paulo, Brazil, Tel: +551633153375; E-mail: jsmarchi@fmrp.usp.br Rec date: Jan 21, 2016; Acc date: Sep 22, 2016; Pub date: Sep 27, 2016 Copyright: © 2016 Franco MMVJ, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Crohn’s disease is a chronic inflammatory intestinal disease associated with increased of pro-inflammatory cytokines, iron deficiency and anaemia. This case report demonstrates a strategy for intravenous iron supplementation in a patient with Crohn´s disease and severe anaemia. This study found an increased in iron and haemoglobin concentrations, malondialdehyde and superoxide dismutase levels and a reduction in glutathione peroxidase (GPx), vitamin A and E. In conclusion the use of intravenous iron probably leads to increase ROS production; this effect may be reduced by using polivitaminics, and enhanced the free radical scavenger. Keywords: Crohn's disease; Anaemia; Iron supplementation; Iron defciency; Oxidative stress Introduction Crohn’s disease (CD) is an idiopathic chronic infammatory intestinal disease (IBD) [1] that afects gastrointestinal tract [2]. Tis disease is characterized by mucosal white blood cells infltration, proinfammatory cytokines and reactive oxygen species (ROS) production. In this context, oxidative stress control is important factor in the IBD progression and recovering [1]. Moreover, severe anaemia is a common complication of IBD, afecting 6% to 74% of the patients [3], having great impact on the mortality [4,5]. Te etiology of anaemia in IBD is multifactorial [6], however, iron defciency (ID) is the primary cause [7,8]. Case Report In this case report, we describe a Caucasian, 18 years-old men with Crohn’s disease who is treated in an Academic Public Hospital. He was a non-smoker, non-alcoholic and denies illicit drug abuse. His family history included a father with obesity, hypertension, smoke habit and a healthy mother. His past medical history includes onset of diarrhoea for ten years, associated with abdominal pain, cramping, fever and vomiting, accompanied with loss of 5 kg in the last 8 months. Te patient received sulfasalazine (50 mg every 8 hours). However, his last ambulatory evaluation revealed a protein calorie malnutrition, perianal fstula, anaemia and iron defciency. Te patient was admitted in metabolic unit of this hospital and it was immediately started iron supplementation afer baseline biochemical analysis. His weight was 29.9 kg, height 1.46 m and body mass index 14.0 kg/m 2 . Te supplementation was carried out for ten days, intravenous being ofered 100 mg iron per day in 200 ml of saline 0.9%. Concomitantly, the patient received parenteral vitamin C supplementation (60 mg/ day). During the supplementation, the patient remained hospitalized, with oral diet that ofered daily 1200 kcal, 40 g of protein, 200 g of carbohydrate and 25 g of lipid. Troughout the internment bowel habit remained 3 times a day. Blood samples were collected on alternate’s day, afer 12 hours of fasting, for biochemical analysis. Haemoglobin and plasma iron values increased (Figure 1). Also, there was an increased in malondialdehyde (MDA) and superoxide dismutase (SOD) levels and a reduction in glutathione peroxidase (GPx), vitamin A and E (Table 1). Te weight remained the same (29.8 kg). Figure 1: Serum iron, Haematocrit and haemoglobin concentration before (Day 1-Baseline) and afer the iron supplementation. MDA (µ mol/l) SOD (U) GPx (µ mol/min/Hb) Vit A (µ mol/l) Vit E (µ mol/l) Day 1 (Baseline) 1.18 1.05 20.45 0.16 4.31 Day 3 1.00 0.90 19.29 0.08 3.04 Day 5 1.02 1.21 16.97 0.02 3.81 Franco et al., J Clin Case Rep 2016, 6:9 DOI: 10.4172/2165-7920.1000858 Case Report Open Access J Clin Case Rep, an open access journal ISSN: 2165-7920 Volume 6 • Issue 9 • 1000858 Journal of Clinical Case Reports J o u r n a l o f C li n i c a l C a s e R e p o r t s ISSN: 2165-7920