HELICOBACTER PYLORI INFECTION AND CHRONIC IRON DEFICIENCY ANEMIA: FEATURES OF COMBINED COURSE AND THERAPY

Purpose: evaluation of pathogenesis and clinical manifestations of H. pylori infection in patients with iron deficiency anemia (IDA) and the assessment of their possible association with variants of the disease, duration of history, gender and age of patients. Material and Methods: The study included 120 patients infected with H. pylori, which subsequently have been divided into two groups. The main group consisted of 70 H. pylori-infected and suffering from iron deficiency anemia patients. Patients of the main groups were randomly divided into two homogeneous groups according to the therapy: 1a subgroup received eradication therapy (ET): amoxicillin (1000 mg twice a day), clarithromycin (500 mg twice a day), esomeprazole 20 mg twice a day for 10 days, then transition to ferrous iron preparations in combination with ascorbic acid after the ET course; 1b subgroup received only a divalent iron preparations in combination with ascorbic acid. The control group (50 persons) consisted of patients infected with H. pylori receiving ET. Infection with H. pylori and control of eradication were confirmed by urea breath test using the Helic test system. Evaluation of the effectiveness of the IDA correction was performed by the monitoring of hemoglobin (Hb) levels, blood color index, total iron binding capacity, ferritin and serum iron. Follow-up assessments of patients were performed on 14th, 28th and 56th day of treatment. Results: Analysis of anemic and sideropenic syndromes on 14th and 28th day of treatment of two subgroups of patients has shown that early response to therapy has been achieved in subgroup 1a. On the 28th day of treatment, the mean Hb level among patient of subgroups 1a was 117.8 g/l (± 29.3 g/l), in patients of subgroup 1b - 104.2 g/l (± 15.6 g/l) (p<0.05). On the 56 th day of treatment, all patients achieved the target values corresponding to the normal Hb level. Dynamics of blood color index on the 28 th and 56th day of the study was also significant in all groups; blood color indices in subgroup 1a were 0.09 and 0.15, respectively, in the subgroup 1b - 0.06 and 0.014, respectively. Moreover, among patients of subgroup 1a target levels were achieved in most patients on the 28th day of treatment (p<0.05). The effectiveness of ET was 80.0% (28 patients) in the subgroup 1a and 82.0% (41 patients) in the control group. Conclusion: ET in patients suffering from chronic iron deficiency anemia allows to achieve a more rapid response to therapy with oral iron preparations, which is confirmed by laboratory parameters.

Helicobacter pylori, iron deficiency anemia, Helicobacter pylori, eradication therapy, serum iron, ferritin, hemoglobin