Cases reported "Anemia, Iron-Deficiency"

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1/5. Successful colectomy for the treatment of repetitive bleeding from colonic angiodysplasia in a patient with Heyde syndrome.

    A 64-year-old man with repetitive gastrointestinal bleeding was admitted to our hospital. Colonic artery angiography revealed angiodysplasia as the bleeding site, and echocardiography showed aortic valve stenosis. A decrease in the high molecular weight von willebrand factor multimers, which are known to play an important role in hemostasis, was observed, and Heyde syndrome was diagnosed. We selected colectomy instead of aortic valve replacement because the patient had undergone two open heart surgeries. Following colectomy, the patient showed a good clinical course without recurrent gastrointestinal bleeding. colectomy might serve as a therapeutic option for Heyde syndrome after the precise site of angiodysplasia is detected by angiography.
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keywords = tea
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2/5. Successful use of sodium ferric gluconate in sucrose in a patient with multiple drug allergies.

    This is not a controlled study but an anecdotal experience that resulted in improved outcomes in a patient with multiple allergies, including iron dextran. Target Hct/Hgbs were attained and exceeded, although iron indices were not fully achieved. Infections demonstrated RE blockade and failure of TSAT to reach target range. The multidisciplinary team's successful decision to trial SFG in a medically complex patient allowed profound iron deficiency to be treated safely and effectively, which was not possible prior to the availability of an alternate iron preparation. It is rewarding to have the option to offer a medication that improves patients' status and enhances outcomes. Mr. C. was less tired and had more energy following his first and subsequent courses of therapy. "I couldn't believe how tired I was without realizing it until after I finished a course of iron therapy. I just thought that was my quality of life on dialysis. It's much better now and I have more energy." Such comments justify our efforts on our patients' behalf.
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3/5. Celiac sprue in an asymptomatic elderly man.

    The authors discuss the case of an asymptomatic patient with celiac sprue presenting with hematologic abnormalities on screening laboratory examination. The patient was initially treated for vitamin B-12 and folate deficiency, and subsequently for iron deficiency with limited success until the diagnosis was established. The absence of such classic features of celiac disease as steatorrhea and diarrhea is not an uncommon presentation. Unexplained iron deficiency should alert the clinician to the possibility of celiac sprue.
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keywords = tea
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4/5. Excessive tea consumption can inhibit the efficacy of oral iron treatment in iron-deficiency anemia.

    intestinal absorption of non-heme food iron may be inhibited by tea, which, on the contrary, does not exert any appreciable effect on heme iron assimilation. Therefore, while an iron-deficiency anemia cannot develop in non-vegetarian subjects as a consequence of tea consumption only, it is possible that tea could inhibit the therapeutic effect of oral iron drugs, which are usually non-hemic ferrous salts, in iron-deficient subjects. This view is supported by the case we describe here, a young woman affected by hypermenorrhea and iron-deficiency anemia, who did not respond to oral iron treatment until she stopped her long-established habit of consuming large quantities of tea. We also believe that oral iron drugs should never be taken together with a cup of tea; therefore we think it useful to advise our iron-deficient patients clearly not to combine tea with the oral consumption of non-hemic ferrous salts.
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5/5. One for tea, not two.

    This case report illustrates a potentially common cause for the inhibition of iron absorption that can be overlooked at the initial consultation and may lead to extensive investigation of a patient with iron deficiency. The case shows that early questioning of the patient regarding their beverage intake can lead to a positive outcome and avoid unnecessary investigation or treatment.
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