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Reversal of Iron Deficiency Anemia after Helicobacter pylori Eradication in Patients with Asymptomatic Gastritis

Bruno Annibale, MD; Massimo Marignani, MD; Bruno Monarca, MD; Giorgio Antonelli, MD; Adriana Marcheggiano, MD; Gina Martino, MD; Franco Mandelli, MD; Renzo Caprilli, MD; and Gianfranco Delle Fave, MD
[+] Article and Author Information

From University La Sapienza, Rome, Italy.


Acknowledgments: The authors thank Ms. Amelia Pasquali for skilled technical support, Prof. J. Osborne for statistical support, and Dr. Edith Lahner for English revision.

Grant Support: By grant no. 02/12/01/10 1992-96 from the Italian Ministry for the University (MURST).

Requests for Reprints: Bruno Annibale, MD, Department of Clinical Medicine, II Clinica Medica, Policlinico Universitario Umberto I, 00161 Rome, Italy. For reprint orders in quantities exceeding 100, please contact the Reprints Coordinator; phone, 215-351-2657; e-mail, reprints@mail.acponline.org.

Current Author Addresses: Drs. Annibale, Marignani, Antonelli, Marcheggiano, Martino, Caprilli, and Delle Fave: Department of Clinical Medicine, II Clinica Medica, Policlinico Universitario Umberto I, 00161 Rome, Italy.

Drs. Mandelli and Monarca: Department of Biotechnology and Hematology, II Clinica Medica, Policlinico Universitario Umberto I, 00161 Rome, Italy.


Ann Intern Med. 1999;131(9):668-672. doi:10.7326/0003-4819-131-9-199911020-00006
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Background: Iron deficiency anemia is the most common form of anemia worldwide. Recent studies have suggested an association between Helicobacter pylori infection and iron deficiency.

Objective: To investigate the effects of eradicating H. pylori with combination antibiotic therapy on iron deficiency anemia in patients with H. pylori-associated gastritis.

Design: Case series.

Setting: University hospital.

Patients: 30 patients with a long history of iron deficiency anemia in whom H. pylori-associated gastritis was the only pathologic gastrointestinal finding detected.

Intervention: Eradication therapy with two antibiotics and discontinuation of iron replacement therapy.

Measurements: Complete blood count, ferritin levels, and gastroscopy with biopsy to evaluate H. pylori status.

Results: At 6 months, 75% of patients had recovered from anemia (P < 0.001), ferritin values increased from 5.7 ± 0.7 µg/L to 24.5 ± 5.2 µg/L (95% CI, 8.85 to 29.97). After 12 months, 91.7% of patients had recovered from anemia.

Conclusions: Cure of H. pylori infection is associated with reversal of iron dependence and recovery from iron deficiency anemia.

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Summary for Patients

Treating Helicobacter pylori Infection May Improve Anemia

The summary below is from the full report titled “Reversal of Iron Deficiency Anemia after Helicobacter pylori Eradication in Patients with Asymptomatic Gastritis.” It is in the 2 November 1999 issue of Annals of Internal Medicine (volume 131, pages 668-672). The authors are B. Annibale, M. Marignani, B. Monarca, G. Antonelli, A. Marcheggiano, G. Martino, F. Mandelli, R. Caprilli, and G. Delle Fave.

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