FREQUENCY AND FEATURES OF LESIONS OF THE UPPER GASTROINTESTINAL TRACT IN PATIENTS WITH LYMPHOPROLIFERATIVE DISEASES AND IRON DEFICIENCY ANEMIA AND THEIR TREATMENT IN RESIDENTS OF TRANSCARPATHIA
DOI:
https://doi.org/10.11603/1811-2471.2023.v.i4.14307Keywords:
H.pylori, upper gastrointestinal disorders, GERD, chronic gastritis, erosion, gastric ulcer and duodenal ulcer, lymphoproliferative diseases, anemia, iron, mountainous and lowland areas, TranscarpathiaAbstract
SUMMARY. An urgent problem of modern clinical medicine is the treatment of patients with lymphoproliferative diseases, which are accompanied by lesions of the gastroesophageal zone, especially against the background of treatment with chemotherapeutic drugs. Among the causes of iron deficiency anemia (IDA) in adulthood, diseases of the blood from the digestive tract of the population occupy a leading place. First of all, IDA can occur as a result of long-term blood loss in erosive and ulcerative lesions of the gastroduodenal zone (EULGZ), viral disease (VD), gastro-esophageal reflux disease (GERD)
The aim – to reveal the specifics of clinical and metabolic disorders of the gastrointestinal tract in patients with various types of gastropathies against the background of lymphoproliferative diseases in the residents of mountainous and lowland regions of the Transcarpathian region in order to optimize diagnosis and treatment tactics.
Material and Methods. We examined 80 patients with lymphoproliferative diseases with various forms of gastroesophageal lesions. Patients with lymphoproliferative diseases were divided into 2 groups: group I included 40 patients with diffuse B-cell lymphoma (DBCL), and group II included 40 patients with myeloma disease (MD). All patients underwent general clinical examinations. Depending on the area of residence, the patients were divided into subgroups: patients of subgroup 1.1 (n=20) and 2.1 subgroup (n=20) were residents of highland areas, and patients of subgroup 1.2 (n=20) and 2.2 subgroup (n=20) were residents of lowland areas.
Results. The analysis of the obtained clinical picture and diagnostic data indicates that patients with lymphoproliferative diseases with gastroesophageal zone lesions living in lowland areas of Transcarpathia have worse clinical symptoms and results of additional examination methods in the form of FEGDS than patients from mountainous areas.
Conclusions. The lesion of the gastroesophageal zone in patients with multiple myeloma and diffuse B-cell lymphoma from lowland areas is clinically more often manifested by esophageal symptoms, while in patients from mountainous areas such symptoms are less common. The gastroesophageal zone lesion in the form of a gastroesophageal reflex was the most common in both study groups, regardless of the patient's place of residence. Patients living in the mountainous region, regardless of the underlying pathology, have better clinical picture and endoscopic findings compared to patients living in the lowland regions of Transcarpathia. Disorders of iron metabolism in the body of patients with EULGZ reflect the participation of compensatory and adaptive systems in the conditions of anemic hypoxia, sideropenia and metabolic intoxication, which should be taken into account in the pathogenetic substantiation of therapy.
References
Kodadek, L.M., & Jones, C. (2018). Stress Gastritis and Stress Ulcers: Prevention and Treatment. Surgical Critical Care Therapy, 231-239. DOI: 10.1007/978-3-319-71712-8_21. DOI: https://doi.org/10.1007/978-3-319-71712-8_21
Weiss, G., Ganz, T., & Goodnungh, L.T. (2019). Anemia of inflammation. Blood, 133(1), 40-50. DOI: 10.1182/blood-201806-856500. DOI: https://doi.org/10.1182/blood-2018-06-856500
Romanenko, T.G., Morozova, O.V., & Sulimenko, O.M. (2020). Prophilaktika ta likuvannya zalizodefizytnoi anemii pry bagatoplidnij vagitnosti [Prevention and treatment of iron deficiency anemia during multiple pregnancy]. Zdorovia zhinky – Health of Woman, 4(150), 51–56 [in Ukrainian]. DOI: https://doi.org/10.15574/HW.2020.150.51
Rukavitsyn, O.A. (Ed.). (2016). Аnemii [Anemias]. Мoskwa: Geotar-Media [in Russian].
Rukavitsin, O.A. (Ed.). (2015). Gematologija: nazional’noe rukovodstvo [Hematology: National Guidelines]. Мoskwa: Geotar-Media [in Russian].
Rumjantsev, A.G. (Ed.). (2015). Detskaja gematologija: klinitcheskie rekomendazii [Pediatric hematology: Clinical recommendations]. Мoskwa: Geotar–Media [in Russian].
Bajdurin, S.A. (2018). Klinicheskaja gematologija: rukovodstvo dlja vrachej [Clinical hematology: A guide for doctors]. Каraganda: «АКНYP» [in Russian].
Greer, J.P., Arber, D.A., & Glader, B. (Eds.). (2014). Wintrobe's clinical hematology (13th ed.). Philadelphia: Lippincott Williams & Wilkins.
Melnyk, D.V. (2018). Vyrazkova chvoroba dvanadzyatypaloii kyshky u ditej shkilnogo viku (ogljad literatury) [Peptic ulcer disease of the duodenum in school-age children (literature review)]. Simeina Medycyna – Family medicine, 3(77), 125-128 [in Ukrainian].
Mukhin, N.A. (2016). Аnemii: kratkoje rukovodstvo [Anemias: A brief guide]. Мoskwa: Geotar-Media [in Russian].
Novak, V.L., Masljak, Z.V., Buzerak, N.F., Berg, L.E., Primak, S.V., & Gutor, T.G. (2015). Pokaznyky diyalnosti gematologichnoji sluzby ukrayiny v 2014 rozi [The performance of the hematology service of Ukraine in 2014]. Lviv [in Ukrainian].
Vydyborets, S.V. (2022). Metabolizm zaliza i zalizodefizytni stany: monographija [Iron metabolism and iron deficiency states: A monograph]. Boston: Published by Primedia eLaunch. DOI: 10.46299/979-8-88831-932-1 [in Ukrainian]. DOI: https://doi.org/10.46299/979-8-88831-932-1
Levina, A.A., Kazyukova, T.V., Tsvetaeva, N.V., Sergeeva, A.I., Mamukova, Y.I., & Romanova, E.A (2008). Gepsidin kak regulator gomeostasa zheleza [Hepcidin as a regulator of iron homeostasis]. Pediatriya – Pediatrics, 87(1), 67-74 [in Russian].
Vydyborets, S.V., & Andriiaka, A.O. (2017). Fiziologichna rol gepsydynu jak zentralnogo regulatora metabolizmu zaliza (ogljad literatury) [The physiological role of hepcidin as a central regulator of iron metabolism (literature review)]. Simeina Medycyna – Family medicine, 1(69), 154-157 [in Ukrainian]. DOI: https://doi.org/10.30841/2307-5112.1(69).2017.103346
Vydyborets, S., & Borysenko, D. (2019). Diagnostychna zinnistj doslidzhennja transferynu na riznych stadijach rozvytku anemii zlojakisnogo novoutvorennja u pazientiv iz urutelialnym rakom setchovogo mihura [Diagnostic value of transferrin in different stages of anemia associated with malignant neoplasms in patients with urothelial bladder cancer]. World Science, 12(52), 1(dec), 25-31. DOI: 10.31435/rsglobal_ws/30122019/6827 [in Ukrainian]. DOI: https://doi.org/10.31435/rsglobal_ws/30122019/6827
Vydyborets, S., & Borysenko, D. (2019). Gepsydyn, transferyn, ferytyn: fiziologichna rol jak zentralnych reguljatoriv obminu zaliza v organizmi [Hepcidin, transferrin, ferritin: The physiological role as central regulators of iron metabolism in the body]. Science Review, 10(27), 8-15. DOI: 10.31435/rsglobal_sr/30122019/6862 [in Ukrainian]. DOI: https://doi.org/10.31435/rsglobal_sr/30122019/6862
WHO Recommendation. (2020). Assesment of iron status in the human body by serum ferritin level. Genewa. Retrieved from: https://www.who.int/publications/i/item/ 9789240000124.
Fadeenko, G.D., & Gridnev, A.E. (2014). Hastroezofahalnyy refleks ta khelikobakter pilori [Gastroesophageal reflux disease and Helicobacter pylori]. Suchasna Gastroenterologia – Modern Gastroenterology, 1(75), 93-95 [in Ukrainian].
Szircsák, E., Sztán, M., Picskár, J., & Kurcsák, N. (2019). Changes in cholecystokinin level in patients with gastroesophageal reflux disease on the background of type 2 diabetes on the background of ursodeoxycholic acid. Abstracts of lectures and posters. Magyar Gasztroenterológiai Társaság 61. Nagygyűlése. Siófok, 183, 156.
Burdulin, N.M., & Tadtayeva, D.Ya. (2012). Influence of intravenous laser therapy on the dynamics of prostaglandins E2 and F2a and the state of microcirculation in patients with GERD. Issues of Balneology, Physiotherapy and Therapeutic Physical Culture, 6, 17-20.
Morozov, S.V., & Kucherjavij, Yu.A. (2013). Treatment of patients with non-erosive form of gastroesophageal reflux disease. Modern view of the problem. Therapist, 7, 32-41.
Cicala, M., Emerenziani, S., Guarino, M.P., & Ribolsi, M. (2013). Proton pump inhibitor resistance, the real challenge in gastroesophageal reflux disease. World J. Gastroenterol, 19(39), 6529-6535. DOI: https://doi.org/10.3748/wjg.v19.i39.6529
