Iron deficiency anemia as a sole presentation of gluten-sensitive enteropathy

Abstract EN

The prevalence of celiac disease has been increased recently due to a greater diagnostic awareness and the wide availability of autoantibodies screening tests in many countries and so diagnostic improvement of celiac disease with wide spectrum of manifestations.

Atypical presentation and monosymptomatic forms of celiac disease are common particularly in adult age group, iron-deficiency anemia is one of these.

In this study, we aimed to describe those cases of celiac disease who presented solely as an iron deficiency anemia and to find if there is any relation between the histopathological damage of intestinal epithelium and the degree of anemia and if gross endoscopic appearance of the duodenum is sensitive for the diagnosis of celiac disease.

The study was conducted on 25 patients; 19 females and 6 males, admitted to Basrah General Hospital over a period of 12 months from September 2000 to September 2001.

All were having iron deficiency anemia without clinical evidence of the underlying cause.

Twenty-two out of 25 were celiac cases responding to gluten free diet.

The degree of histological damage was correlated with the extent of anemia and was lowest in case of damaged epithelium.

Gross endoscopic findings have a sensitivity of 63 % and specificity of 100 %.

Conclusion: Celiac disease is the major underlying cause of iron deficiency anemia of unexplained nature.

The severity of the later was related to extent of histological damage.

Gross endoscopic findings have a specificity of 100 % and a sensitivity of 63 %.