Celiac disease prevalence in patients with iron deficiency anemia of obscure origin
Derya Uçardağ1, Sefa Güliter, Ozcan Ceneli
1Department of Internal Medicine, Kirikkale University, School of Medicine, Kirikkale.
Insights
Celiac disease is more common in Turkish patients with unexplained iron deficiency anemia. Early screening for celiac disease is recommended for these patients to improve diagnosis.
Area of Science:
- Gastroenterology
- Immunology
- Hematology
Background:
- Iron deficiency anemia is a common complication of celiac disease.
- The prevalence of celiac disease in Turkish patients with unexplained iron deficiency anemia requires further investigation.
Purpose of the Study:
- To determine the prevalence of celiac disease in Turkish patients presenting with iron deficiency anemia of obscure origin.
- To evaluate the utility of serological screening for celiac disease in this patient population.
Main Methods:
- Evaluated 1,486 patients with iron deficiency anemia for etiology, identifying 77 with unexplained anemia.
- Tested sera from 77 patients and 119 controls for IgA and IgG anti-tissue transglutaminase (tTG) antibodies.
- Performed endoscopic duodenal biopsies and classified findings using the Marsh criteria.
Main Results:
- Anti-tTG antibodies were detected in 7.8% (IgA) and 3.9% (IgG) of patients with unexplained anemia.
- Histopathologic findings consistent with celiac disease were present in 7.8% of patients versus 0.8% of controls (p=0.02).
- A higher prevalence of celiac disease was observed in patients with unexplained iron deficiency anemia.
Conclusions:
- Patients with iron deficiency anemia of obscure origin exhibit an increased prevalence of celiac disease.
- Serological screening for celiac disease should be considered for early detection in patients with unexplained iron deficiency anemia.
Background/Aims:
Anemia, especially due to iron deficiency, is a frequent feature in celiac disease. In this study, we aimed to define the prevalence of celiac disease in Turkish patients with iron deficiency anemia of obscure origin.
Methods:
One thousand four hundred and eighty-six consecutive patients with iron deficiency anemia were evaluated for etiology. Of those, 77 patients were found to have iron deficiency anemia of obscure origin. Sera from 77 patients with iron deficiency anemia of obscure origin and 119 healthy controls were tested for IgA and IgG tissue transglutaminase (tTG) antibodies by ELISA. Endoscopic mucosal biopsies were taken from the second part of the duodenum in these patients. Histopathologic examination results of patients were stratified according to Marsh classification.
Results:
IgA and IgG class anti-tTG antibodies were found positive in 6 (7.8%) and 3 (3.9%) patients with iron deficiency anemia of obscure origin, respectively. Three patients had only IgA anti-tTG and 3 had both IgA and IgG anti-tTG antibodies. In the control group, 1 subject was positive for both IgA and IgG anti-tTG antibodies (0.7%). Six patients (7.8%) and 1 control subject (0.8%) had histopathologic findings of celiac disease (p=0.02).
Conclusions:
Patients with iron deficiency anemia of obscure origin had increased prevalence of celiac disease. Our study results suggest that serological screening may be recommended for early detection of celiac disease in patients with iron deficiency anemia of obscure origin.
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