Hematologic Manifestations in Celiac Disease-A Practical Review

Area of Science:

• Immunology
• Gastroenterology
• Hematology

Background:

• Celiac disease (CD) is an autoimmune disorder triggered by gluten in genetically susceptible individuals.
• While primarily affecting the small intestine, CD can manifest with extraintestinal symptoms, including hematologic abnormalities.
• Hematologic manifestations are common in CD and can be the sole presenting feature.

Purpose of the Study:

• To review recent evidence on hematologic manifestations of celiac disease.
• To provide practical recommendations for clinicians in diagnosing CD based on hematologic findings.
• To highlight the importance of recognizing atypical CD presentations to improve diagnosis rates.

Main Methods:

• Literature review of recent evidence on celiac disease and hematologic manifestations.
• Synthesis of findings related to anemia, thrombocytosis, thrombotic/hemorrhagic events, IgA deficiency, hyposplenism, and lymphoma in CD.
• Focus on clinical scenarios where hematologic alterations prompt CD testing.

Main Results:

• Hematologic alterations such as anemia and thrombocytosis are frequent extraintestinal manifestations of CD.
• These hematologic changes can be the primary or only sign of celiac disease.
• Current diagnostic rates for CD are low, underscoring the need for awareness of its diverse presentations.

Conclusions:

• Hematologic manifestations are significant indicators of celiac disease and warrant investigation.
• Early recognition of these extraintestinal signs can improve the diagnosis of underdiagnosed celiac disease.
• Clinicians should consider CD testing in patients presenting with suggestive hematologic abnormalities.