معدل انتشار الداء الزلاقي عند مرضى فقر الدم بعوز الحديد في مستشفى الأطفال الجامعي بدمشق

Abstract EN

Objective: Celiac disease is an autoimmune-like systemic disorder in genetically susceptible persons perpetuated by the daily ingested gluten cereals wheat, rye, and barley with manifestations in the intestine and in organs outside the gut such as (iron deficiency anemia).

Today it is understood that the nature of celiac disease is much more complex than simply intestinal malabsorption, which, as such, is -in fact- no longer essential for the diagnosis.

Iron-deficiency anemia is the most commonly encountered anemia in humans.

Iron-deficiency anemia also is a common extra-intestinal manifestation of celiac disease.

We do this study to determine the celiac disease prevalence in children with iron-deficiency anemia and to compare the hematologic parameters in iron-deficiency anemia patients with and without celiac disease in Children's University Hospital in Damascus.

Methods: The study was conducted at Children's University Hospital in Damascus, a prospective study between 2015 and 2016 included 75 children diagnosed with iron-deficiency anemia.

Hemoglobin, red cell indices (mean corpuscular volume MCV), serum iron, and serum ferritin were determined.

Venous blood samples for anti-tissue trans-glutaminase antibody immunoglobulin A were obtained from these patients.

Upper gastrointestinal endoscopy was recommended to patients who had positive serology.

We categorized patients into one group of iron-deficiency anemia patients with celiac disease, and one group of iron-deficiency anemia patients without celiac disease, we collected results and then we compared its by SPSS.

Results: Of 75 patients with iron-deficiency anemia, 11 (14.6%) had positive serology for celiac disease.

The small intestine biopsy of all patients with positive serology showed villous atrophy (Marsh 3b in 7 patients, Marsh 3c in 4 patients).

The mean hemoglobin level was significantly lower in iron-deficiency anemia patients with celiac disease when compared to those without celiac disease (8.1±1.5 vs.

10.5±1.2 g/dl, p<0.05), serum iron and mean corpuscular volume were significantly lower in iron-deficiency anemia patients with celiac disease when compared to those without celiac disease (p<0.05), serum ferritin was lower in iron-deficiency anemia patients with celiac disease when compared to those without celiac disease (p>0.05).

Conclusions: Screening of celiac disease by anti-tissue trans-glutaminase antibody should be done as a routine investigation in children with iron-deficiency anemia.

Biopsy should be recommended in patients with iron-deficiency anemia who have positive celiac disease serology