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Severe Anemia

I used to lurk here (like 10 years ago) while my husband was dealing with a massive Crohn's flare. He's been mostly in remission since surgery in 2008. He was on Remicade for a year after surgery and then switched to Humira, which he is still on.

Anywho...about 2 years ago, he started feeling really exhausted for no reason (he's an athlete) and had a bunch of blood run and had signs of severe anemia and was rushed in for a series of infusions. That worked for about a year and then about 6 months ago, started feeling the same way. Blood tests showed basically zero iron and he went in for another set of infusions. Those didn't seem to last very long and he had ANOTHER series of 6 infusions about 2 months ago.

He just got his blood tests back today because he's been feeling faint and his iron level is at a 5. I can't remember the other markers, but they are VERY low. He's going to be referred to a hematologist as a next step, but I'm super worried about him. He had a double scope last month and it showed very little active disease. He feels great other than the anemia issues.

Is there anyone who has dealt with similar issues. Iron infusions not working? We are worried about other conditions (cancer being one) and I'm just freaked out. We just built a house and had a baby, my Dad was just diagnosed with Lymphoma, and my Mom had breast cancer this summer. I'm fried from all this and just want to get my hubby healthy again. Looking for anyone with similar experience.
 
Does he have iron deficiency anemia, anemia of inflammation, or both? Since it is a disease of inflammation that also commonly results in poor iron absorption and/or blood loss from the gut, any of these types of anemia can occur with Crohn's. A thorough battery of blood tests should be able to tell what type of anemia your husband has.

The scopes are not very good at assessing what's going on in the small bowel. The Crohn's may be flaring in there and causing blood loss. You may wish to suggest to the doctor that your husband get a capsule camera endoscopy and/or MRE assessment of the small bowel. And if the Crohn's is acting up in the small bowel then more aggressive medication may be needed to quell the flare and clear up the anemia.
 
I agree with Scipio. I had anemia too when i was on humira and it was not working that much for me and crohns was active.

How are the inflammatory markers like pcr and fecal calprotectin? If they are increased that may be a sign of active disease too.

A first solution could be to increase the dose of humira.
Try not thinking to the worst case scenario, anemia with crohn is very common unfortunately
 
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