Dig Liver Dis. 2024 Mar 18:S1590-8658(24)00277-9.doi: 10.1016/j.dld.2024.02.016. Online ahead of print.

Massimo Martinelli ¹, Maria Teresa Fioretti ¹, Marina Aloi ², Patrizia Alvisi ³, Serena Arrigo ⁴, Claudia Banzato ⁵, Matteo Bramuzzo ⁶, Angelo Campanozzi ⁷, Fortunata Civitelli ⁸, Daniela Knafelz ⁹, Paolo Lionetti ¹⁰, Antonio Marseglia ¹¹, Francesca Musto ², Lorenzo Norsa ¹², Giuseppe Palumbo ¹³, Sara Renzo ¹⁰, Claudio Romano ¹⁴, Naire Sansotta ¹⁵, Caterina Strisciuglio ¹⁶, Erasmo Miele ¹⁷

Author information

¹Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II".

²Women's and Children's Health Department, Pediatric Gastroenterology and Hepatology Unit, Sapienza University of Rome, Rome, Italy.

³Pediatric Gastroenterology Unit, Maggiore Hospital, Bologna, Italy.

⁴Pediatric Gastroenterology and Endoscopy Unit, IRCCS Giannina Gaslini, Genova, Italy.

⁵Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Division, University of Verona, Verona, Italy.

⁶Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy.

⁷Department of Medical and Surgical Sciences, Section of Pediatrics, University of Foggia, Italy.

⁸Department of Gender diseases, Child and Adolescent health, Pediatric unit, Sant' Eugenio Hospital, Rome, Italy.

⁹Hepatology and Gastroenterology Unit, Bambino Gesù Hospital, Rome, Italy.

¹⁰University of Florence-Gastroenterology and Nutrition Unit, Meyer Children's Hospital, IRCCS, Florence.

¹¹Fondazione IRCCS Casa Sollievo della Sofferenza, Division of Pediatrics, San Giovanni Rotondo, Italy.

¹²Pediatric Department Vittore Buzzi Children's Hospital, University of Milan, Italy.

¹³Department of Haematology, Bambino Gesù Hospital, 00165 Rome, Italy.

¹⁴Pediatric Gastroenterology and Cystic Fibrosis Unit, University of Messina, Messina, Italy.

¹⁵Paediatric Hepatology Gastroenterology and Transplantation, Papa Giovanni XXIII Hospital, Bergamo, Italy.

¹⁶Department of Woman, Child and General and Specialistic Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.

¹⁷Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II". Electronic address: erasmo.miele@unina.it.

Abstract

Anemia is one of the most frequent extra-intestinal manifestations of inflammatory bowel disease. Insidious onset, variability of symptoms and lack of standardized screening practices may increase the risk of underestimating its burden in children with IBD. Despite its relevance and peculiarity in everyday clinical practice, this topic is only dealt with in a few documents specifically for the pediatric field. The aim of the current guidelines is therefore to provide pediatric gastroenterologists with a practical update to support the clinical and therapeutic management of children with IBD and anemia. A panel of 19 pediatric gastroenterologists and 1 pediatric hematologist with experience in the field of pediatric IBD was agreed by IBD Working group of the Italian Society of Gastroenterology, Hepatology and Nutrition (SIGENP) to produce the present article outlining practical clinical approaches to the pediatric patient with IBD and anemia. The levels of evidence and recommendations have been defined for each part of the statement according to the GRADE system.