Prevalence of Celiac Disease in Patients With Iron Deficiency Anemia-A Systematic Review With Meta-analysis

Area of Science:

• Gastroenterology
• Internal Medicine
• Clinical Diagnostics

Background:

• Anemia, particularly iron-deficiency anemia (IDA), is frequently observed in patients with celiac disease (CD).
• Current medical guidelines advocate for screening individuals with IDA for CD.
• The precise prevalence of CD among IDA patients remains variable in existing literature.

Purpose of the Study:

• To conduct a systematic review and meta-analysis to determine the prevalence of biopsy-verified celiac disease (CD) in patients presenting with iron-deficiency anemia (IDA).

Main Methods:

• A systematic literature search was performed using PubMed Medline and EMBASE databases up to July 2017.
• Studies were identified using keywords "celiac disease" combined with "anemia" or "iron deficiency."
• Fixed-effects inverse variance-weighted models were employed to calculate the pooled prevalence of CD, with meta-regression used to analyze heterogeneity.

Main Results:

• The analysis included 18 studies encompassing 2998 patients with IDA, with CD prevalence identified in 4.8% (unweighted) and 3.2% (weighted pooled analysis).
• High heterogeneity (I² = 67.7%) was noted, but subgroup analyses and meta-regression did not reveal significant associations with age, sex, or publication year.
• In 8 high-quality studies, the pooled prevalence of biopsy-confirmed CD was 5.5% (95% CI = 4.1-6.9).

Conclusions:

• This systematic review and meta-analysis indicates that approximately 1 in 31 patients with IDA have biopsy-confirmed celiac disease.
• The findings support the established clinical practice of screening patients with iron-deficiency anemia for celiac disease.