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Celiac disease presenting as iron-deficiency anemia in northern India
S Varma1, P Malhotra, R Kochhar
1Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh. svarma@cha.i91.net
Insights
Celiac disease, though rare in India, can present as refractory iron-deficiency anemia. Investigating this condition is crucial for patients with unexplained anemia, as a gluten-free diet can lead to significant improvement.
Area of Science:
- Gastroenterology
- Hematology
- Internal Medicine
Background:
- Adult celiac disease is uncommon in India.
- Iron-deficiency anemia is a rare presenting symptom of celiac disease.
Purpose of the Study:
- To investigate the prevalence of celiac disease in patients with refractory iron-deficiency anemia.
- To assess the diagnostic utility of histology, serology, and treatment response in identifying celiac disease.
Main Methods:
- Patients with refractory iron-deficiency anemia were evaluated for celiac disease.
- Diagnostic criteria included histological examination, serological tests, and response to a gluten-free diet.
Main Results:
- Celiac disease was diagnosed in 11 out of 19 patients with refractory iron-deficiency anemia.
- Abnormal D-xylose tests were observed in 4 patients, and fat malabsorption in 3.
- All diagnosed patients showed improved hematological parameters after adhering to a gluten-free diet.
Conclusions:
- Refractory iron-deficiency anemia of unknown etiology warrants investigation for subclinical celiac disease.
- Early diagnosis and dietary intervention can effectively manage celiac disease presenting with anemia.
Background:
Adult celiac disease is infrequent in India. Iron-deficiency anemia as its presenting manifestation is still rarer.
Methods:
We investigated patients with refractory iron-deficiency anemia attending the hematology clinic of a tertiary-care hospital for celiac disease. The diagnosis of celiac disease was based on histology, serology and response to treatment.
Results:
Of 19 patients with refractory iron-deficiency anemia seen from April 1998 to March 2000, 11 were diagnosed to have celiac disease. Four of these had abnormal D-xylose test and 3 had fat malabsorption. All 11 patients responded to gluten-free diet with improvement in hematological parameters.
Conclusion:
Patients with refractory iron-deficiency anemia of unknown cause should be investigated for subclinical celiac disease.