Case Report

Anemia defisiensi besi pada pasien dengan ulkus peptikum: Laporan kasus

I Dewa Agung Gede Agastya Janardhana , I Dewa Gede Agung Suta Ariwangsa

I Dewa Agung Gede Agastya Janardhana
Fakultas Kedokteran dan Ilmu Kesehatan, Universitas Warmadewa, Bali, Indonesia. Email:

I Dewa Gede Agung Suta Ariwangsa
Fakultas Kedokteran dan Ilmu Kesehatan, Universitas Warmadewa, Bali, Indonesia
Online First: April 01, 2021 | Cite this Article
Janardhana, I., Ariwangsa, I. 2021. Anemia defisiensi besi pada pasien dengan ulkus peptikum: Laporan kasus. Intisari Sains Medis 12(1): 113-116. DOI:10.15562/ism.v12i1.860

Background: Anemia is a decrease in hemoglobin levels from the standard limit that can be caused by iron deficiency and chronic bleeding. One-third (32.9%) of the world population is estimated to suffer from anemia, and iron deficiency is a common cause of anemia in all countries. The diagnosis is made through history taking, physical examination and investigations.

Case report: 59-year-old male patient with complaints of black stool, abdominal pain and weakness. On physical examination, found pale conjunctiva, angular stomatitis and atrophy of the tongue. On complete blood, the examination found a decrease in erythrocyte levels, hemoglobin, MCV, MCH, and MCHC and increased RDW-CV. Analysis of peripheral blood smears presents with hypochromic microcytic poikilocytosis anemia, serum iron is decreased, and increased TIBC. Chronic bleeding anemia accompanied by iron deficiency will cause ferritin levels to decrease or be normal to 60 µg / dl. The patient was diagnosed with peptic ulcers as seen from esophagoduodenoscopy and severe anemia caused by iron deficit and chronic bleeding. Patients were treated supportively with PRC transfusion, ferrous sulfate and vitamin C.

Conclusion: The patient’s iron deficiency anemia resulted from peptic ulcers, which caused chronic bleeding.



Latar belakang: Anemia merupakan kondisi dengan kadar hemoglobin yang lebih rendah dari nilai normal. Anemia dapat disebabkan akibat defisiensi besi atau perdarahan kronis. Sebesar sepertiga (32,9%) populasi didunia diperkirakan menderita anemia. Defisiensi besi merupakan penyebab umum anemia di seluruh negara. Penegakan diagnosis anemia dilakukan melalui anamnesis, pemerikaan fisik, dan pemeriksaan penunjang.

Laporan kasus: Pasien laki-laki 59 tahun dengan keluhan BAB hitam, nyeri perut dan lemas. Pada pemeriksaan fisik ditemukan konjungtiva anemis, stomatitis angularis dan atrofi papil lidah. Pada pemeriksaan darah lengkap ditemukan penurunan kadar eritrosit, Hemoglobin, MCV, MCH, dan MCHC, peningkatan RDW-CV. Pemeriksaan apusan darah tepi gambaran anemia bikromik mikrositer poikilositosis, serum besi menurun, dan peningkatan TIBC. Anemia perdarahan kronis disertai defisiensi besi akan menimbulkan kadar ferritin menurun atau normal hingga 60µg/dl. Pasien didiagnosis dengan ulkus peptikum dilihat dari hasil Esofagoduodenoskopi dan anemia berat yang disebabkan oleh defisensi besi dan perdarahan kronis.  Pasien diterapi suportif dengan Tranfusi PRC, pemberian ferrous sulphate dan vitamin C.

Kesimpulan: Anemia defisiensi besi pada pasien ditimbulkan oleh ulkus peptikum yang menyebabkan terjadinya perdarahan kronis.



WHO, Iron Deficiency Anemia: Assessment, Prevention, and Control, A guide for programme managers.Geneva: World Health Organization, 2001 Accessed 26 March, 2020 available at

Kassebaum NJ, Jasrasaria R, Naghavi M, et al. A systematic analysis of global anemia burden from 1990 to 2010. Blood. 2014;123(5):615-624 Accessed 26 March, 2020 available at

World Health Organization. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. Geneva:World Health Organization. 2011 Accessed 26 March, 2020 available at

Patel KV. Epidemiology of anemia in older adults. Semin hematol. 2008;45(4):11-20. Accessed 26 March, 2020 available at

Jimenez K, Kulnigg-Dabsch S, Gasche C. Management of iron deficiency Anemia. Gastroenterol Hepatol. 2015;11(4):241–50. Accessed 1 April 2020 Available at

Johnson Wimbley TD, Graham DY. Diagnosis and management of iron deficiency anemia in the 21st century. Therap Adv Gastroenterol. 2011;4(3):177–84. Accessed 1 April 2020 Available at

Kemenkes RI. Riset Kesehatan Dasar; RISKESDAS. Jakarta: Balitbang Kemenkes RI. 2013

Bakta IM. Hematologi Klinik Ringkas. Jakarta: EGC; 2015. p. 31

Bridges K, Pearson H. Anemias and Other Red Cell Disorder., Tropical Medicine. Connecticut: McGraw Hill Medical; 2008. p. 100–101

Cappellini MD, Musallam KM, Taher AT. Iron deficiency anaemia revisited. J Intern Med. 2019;287(2):153–70. Accessed 1 April 2020 Available at

Madu AJ, Ughasoro MD. Anaemia of Chronic Disease: An In-Depth Review. Med Princ Pract. 2017;26(1):1–9. Accessed 1 April 2020.

No Supplementary Material available for this article.
Article Views      : 16
PDF Downloads : 10