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Iron deficiency anemia in newly diagnosed celiac disease in children
Maria T Sanseviero1, Giuseppe A Mazza, Maria N Pullano
1Pediatric Unit, Regional Centre for Diagnosis and Follow‑up of the Celiac Disease "Magna Graecia" University of Catanzaro Catanzaro, Italy - roberto.miniero@unicz.it.
Insights
Iron deficiency anemia (IDA) is common in children diagnosed with celiac disease (CD). Pediatricians should screen for iron depletion and IDA in children with newly diagnosed CD to ensure timely treatment.
Area of Science:
- Pediatric Gastroenterology
- Hematology
Background:
- Celiac disease (CD) presents with diverse symptoms in children, with anemia being the most common extraintestinal manifestation.
- Iron deficiency anemia (IDA) is a frequent presentation of anemia in pediatric celiac disease.
Purpose of the Study:
- To evaluate the prevalence and characteristics of IDA in a large cohort of children newly diagnosed with celiac disease.
Main Methods:
- A cohort of 518 children (6 months-18 years) diagnosed between 1990-2013 were analyzed.
- Hematological parameters including hemoglobin, serum iron, serum ferritin, and serum transferrin levels were assessed.
- IDA was diagnosed based on hemoglobin levels below -2SD, with reduced serum iron and ferritin, and increased serum transferrin.
Main Results:
- Anemia was present in 30.1% of patients, with 21.62% diagnosed with IDA.
- 18 cases of IDA were associated with alpha- or beta-thalassemia trait.
- 22.20% of patients exhibited preanemic iron deficiency with low ferritin levels but normal hemoglobin.
Conclusions:
- Iron depletion and IDA are common findings at the time of celiac disease diagnosis in children.
- The significant association between celiac disease and iron deficiency necessitates consideration by pediatricians during diagnosis.
- Early identification and treatment of iron deficiency in pediatric celiac disease patients are crucial.
Background:
Celiac disease (CD) in children may occur with a wide spectrum of clinical manifestations: anemia is the most frequent extraintestinal manifestation, iron deficiency anemia (IDA) is the common presentation. In our study we aimed to assess IDA condition in a large cohort of pediatric patients with newly diagnosed CD.
Methods:
Our study includes a cohort of 518 children (340 females and 178 males), 6 months-18 years old, joined between January 1990 and January 2013. We have analyzed hematological parameters and iron balance: serum iron, serum ferritin and serum transferrin levels. The diagnosis of IDA was considered on the basis of hemoglobin levels below -2SD, associated with serum iron and ferritin reduction, serum transferrin increase; all compared with the normal reference values for age.
Results:
Of all patients, 156 patients (30.1%) had anemia, including 103 females (19.8%) and 53 males (10.2%); of these, 112 (21.62%) had IDA (in 18 cases associated with α- or β-thalassemia trait), 22 were thalassemic trait without iron deficiency and the remaining 19 suffered from other forms of anemia. One hundred fifteen patients (22.20%) with low ferritin levels but normal hemoglobin levels were considered as preanemic iron deficient patients.
Conclusion:
Our data confirm that iron depletion and IDA represent a frequent finding at the diagnosis of CD. This significant relation existing between CD and iron deficiency should be considered by pediatricians at the diagnosis of CD in order to treat the patients.
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