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[Sideropenic anemia and celiac disease]
Insights
Antigliadin antibodies (AGA) aid in diagnosing coeliac disease (CD), including atypical forms. Screening for CD is crucial in patients with unexplained iron deficiency anemia, as it can be an isolated symptom.
Area of Science:
- Gastroenterology and Hepatology
- Pediatric Hematology
- Immunology
Context:
- Coeliac disease (CD) diagnosis has increased with Antigliadin Antibodies (AGA) screening, revealing more monosymptomatic and atypical cases.
- Iron deficiency anemia is a common manifestation of CD, appearing alone or with other symptoms.
Purpose:
- To determine the incidence of iron deficiency anemia in diagnosed coeliac disease patients.
- To assess the prevalence of coeliac disease in pediatric patients with unexplained, iron-refractory anemia.
Summary:
- 48.5% of 212 coeliac patients presented with hypochromic, microcytic anemia.
- 6.2% of 96 pediatric patients with unexplained anemia were diagnosed with CD based on positive AGA, Antiendomysium Antibodies (AEA), and jejunal biopsy.
Impact:
- Confirms a high association between coeliac disease and iron deficiency anemia.
- Highlights the importance of screening for coeliac disease in patients with unexplained hypochromic anemia to identify this monosymptomatic presentation.
Abstract:
Since the beginning of the use of Antigliadin Antibodies (AGA) in the screening of coeliac disease (CD) we have observed an increasing in the total number of cases diagnosed, in particular of the cases with monosymptomatic and atypical forms. Iron deficiency anemia is one of the more frequent findings that we can find in CD, either in association with other typical coeliac signs, or as an isolated expression of the disease. The first aim of our study was to determine the incidence of iron deficiency anemia in our patients affected by CD at the moment of diagnosis. The second aim was to determine the incidence of CD in a group of 96 patients attending our Pediatric Hematology department for iron deficiency anemia of unknown etiology and refractory to iron therapy. 103 patients out of our 212 coeliacs (48.5%) showed hypochromic and microcytic anemia. In the second sample we found 6 (6.2%) patients, positive in AGA and Antiendomysium Antibodies (AEA), that showed a typical coeliac picture at the jejunal biopsy. Our study confirms the high incidence of iron deficiency anemia in patients affected by coeliac disease. However the most important conclusion of our study is that a certain percentage of patients affected by hypochromic anemia of unknown etiology may be affected by coeliac disease. It is only by performing the specific screening tests (AGA and AEA) in the patients affected by iron deficiency anemia of unknown etiology, that we can diagnose this monosymptomatic expression of CD.