• Olga Kaczmarczyk, Magdalena Przybylska-Feluś, Agnieszka Piątek-Guziewicz, Kacper Wcisło, Mirosław Krośniak, Jadwiga Kryczyk-Kozioł, Krzysztof Kleszcz, Paweł Zagrodzki, Dorota Cibor, Tomasz Mach, and Małgorzata Zwolińska-Wcisło.
• Department of Gastroenterology and Hepatology, University Hospital, Kraków, Poland
• Pol. Arch. Med. Wewn. 2020 Mar 27; 130 (3): 179-186.

IntroductionProton pump inhibitors (PPIs) are widely prescribed for several gastrointestinal conditions, often as long‑term therapy. The effects of term PPI use have not been fully elucidated.ObjectivesWe aimed to determine the association between long‑term PPI use and complete blood count parameters, particularly red blood cell (RBC) count, white blood cell (WBC) count, and hemoglobin concentrations, as well as serum levels of selected micronutrients such as selenium (Se), iron (Fe), copper (Cu), and zinc (Zn).Patients And MethodsWe enrolled 37 patients on long‑ term PPI therapy (mean [SD] age, 57.1 [15.4] years) and 30 healthy controls (mean [SD] age, 39.3 [11.8] years). In each group, complete blood count, and serum Fe levels were performed, and serum Cu, Zn, and Se levels were measured using atomic absorption spectrometry.ResultsRed blood cell and WBC counts were lower in the PPI group compared with controls (mean [SD], 4.24 [0.55] ×106/μl vs 4.7 [0.4] ×106/μl; P <0.001 and 6.13 [1.44] ×103/μl vs 7.3 [1.28] ×103/μl; P <0.001, respectively). Hemoglobin and serum Fe concentrations were also lower in the PPI group (mean [SD], 12.5 [1.8] g /dl vs 14.3 [0.8] g /dl; P <0.001 and 16.3 [5.4] μmol/l vs 23.4 [2.7] μmol/l; P <0.001, respectively). Serum Zn and Cu concentrations were higher in PPI users than in controls.ConclusionsLong‑term PPI therapy may reduce RBC and WBC counts as well as hemoglobin levels, leading to iron deficiency. It may also aff ect concentrations of some micronutrients, although the underlying mechanism of this association is not fully clear.

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