Anaemia Remains Common in Paediatric IBD

ANAEMIA was common among patients with paediatric-onset inflammatory bowel disease (PIBD) at diagnosis and remained associated with disease activity during the following five years, according to a Danish nationwide cohort study. 

Anaemia Common at PIBD Diagnosis 

Researchers investigated the prevalence and subtypes of anaemia among patients aged 6–17 years diagnosed with PIBD between 2014 and 2022. They also examined whether anaemia was associated with disease activity over the five years following diagnosis. 

The study used Danish national health registers to identify 1,266 incident patients with PIBD. Anaemia was defined according to WHO criteria, while anaemia subtypes were classified using guidelines from the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition. 

At diagnosis, 660 patients, equivalent to 52% of the cohort, had anaemia. Although prevalence declined during follow-up, anaemia remained present in 25% of patients in year five. 

Mixed Anaemia Subtype Predominates 

The severity of anaemia changed over time. Moderate anaemia was most frequently observed at diagnosis and during the first year, whereas mild anaemia became more common in subsequent years. 

Among patients who had anaemia at diagnosis, 237 could be assigned an anaemia subtype. Iron deficiency anaemia (IDA) was identified in 25 patients, representing 11%, while 44 patients, or 19%, had anaemia of chronic disease (ACD). The largest group had both IDA and ACD, affecting 168 patients, or 71%. 

These findings indicated that combined iron deficiency and chronic disease contributed substantially to the anaemia observed at PIBD diagnosis. 

Anaemia Associated with Disease Activity 

The study also found an association between anaemia and disease activity throughout the five-year follow-up period. Disease activity was assessed using medication use, surgical procedures, and hospitalisation. 

The strongest association was observed in year four, when patients with anaemia had more than twice the risk of disease activity compared with those without anaemia (adjusted risk ratio: 2.3; 95% CI: 1.8–3.0). 

The researchers concluded that anaemia represented a frequent feature of PIBD, particularly at diagnosis, and remained prevalent despite declining over time. The persistent association between anaemia and disease activity further highlighted its relevance during follow-up. The findings also identified IDA combined with ACD as the predominant subtype at diagnosis. 

Reference  

Norup JR et al. Anaemia in patients diagnosed with paediatric-onset inflammatory bowel disease: a Danish nationwide cohort study. J Pediatr Gastroenterol Nutr. 2026;DOI:10.1002/jpn3.70557.  

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