ORIGINAL ARTICLE Safety and Efficacy of Total-Dose Infusion of Low Molecular Weight Iron Dextran for Iron Deficiency Anemia in Patients with Inflammatory Bowel Disease Ioannis E. Koutroubakis • Pantelis Oustamanolakis • Christos Karakoidas • Gerassimos J. Mantzaris • Elias A. Kouroumalis Received: 7 August 2009 / Accepted: 30 September 2009 / Published online: 16 October 2009 Ó Springer Science+Business Media, LLC 2009 Abstract Background Intravenous iron has been suggested as a safe and effective treatment of anemia complicating inflammatory bowel disease (IBD). Low molecular weight (LMW) iron dextran has the ability to administer the patient’s total iron requirement in a single infusion. Aims The aim of this study was to assess the safety and efficacy of the total dose of LMW iron dextran infusion for the treatment of iron deficiency in IBD. Methods Fifty IBD patients (27 female, 35 Crohn’s dis- ease, 15 ulcerative colitis) were included in the study. Mean ± standard deviation (SD) hemoglobin and ferritin levels before the infusion were 9.88 ± 1.42 g/dl and 13.9 ± 10.9 ng/ml, respectively. A 25-mg test dose was followed by infusion of the total dose of LMW iron dextran based on the iron deficit. Several clinical and laboratory parameters were measured before and on week 4 after infusion. Results Four patients (8%) developed adverse reactions during the test infusion and did not receive the total-dose infusion. Only one patient developed an allergic reaction during the total-dose infusion. In the remaining 45 patients, the mean ± SD iron dose that was given was 1,075 ± 269 mg. The mean ± SD elevation of hematocrit and hemoglobin on week 4 was 4.9 ± 1.9% and 1.7 ± 0.8 g/ dl, respectively. Hematopoietic response was observed in 23 of 45 patients (51.1%). Conclusion Total parenteral iron replacement with LMW iron dextran is an easy, safe, and effective alternative method for treating iron deficiency anemia in IBD. Harmless adverse reactions may develop in a minority of patients. Keywords Anemia Á Crohn’s disease Á Infusions Á Iron deficiency anemia Á Ulcerative colitis Introduction Anemia is a common and important complication of inflammatory bowel disease (IBD), associated with a decrease in quality of life and increased rate of hospital- ization [1, 2]. The correction of anemia has recently been highlighted as a specific therapeutic goal [3, 4]. Although the cause of anemia in IBD is multifactorial, it is usually due to iron deficiency. Therefore, treatment with iron supplementation is important and it should be initiated when iron deficiency anemia is present. Recent guidelines suggest that iron supplementation should be preferably administered intravenously in IBD, even though many patients will respond to the oral administration of iron [5]. This is because oral iron is limited by poor absorption, intolerance, and induction of I. E. Koutroubakis (&) Á P. Oustamanolakis Á E. A. Kouroumalis Department of Gastroenterology, University Hospital Heraklion, P.O. Box 1352, 71110 Heraklion, Crete, Greece e-mail: ikoutroub@med.uoc.gr; ktjohn@her.forthnet.gr P. Oustamanolakis e-mail: pantelis@vodafone.net.gr E. A. Kouroumalis e-mail: kouroum@med.uoc.gr C. Karakoidas Á G. J. Mantzaris 1st Department of Gastroenterology, Evangelismos Hospital Athens, Athens, Greece C. Karakoidas e-mail: ChKarako@otenet.gr G. J. Mantzaris e-mail: gman195@yahoo.gr 123 Dig Dis Sci (2010) 55:2327–2331 DOI 10.1007/s10620-009-1022-y