Celiac disease is unrecognized and under-investigated, especially in anemic menstruating women, according to research reported in December's British Journal of Haematology.
A team from the Southmead and Frenchay Hospitals, Bristol, England, investigated the incidence of celiac disease in patients with iron deficiency anemia.
In a 4-month period, 110,973 blood-donor volunteers were seen. Of these, 1% (1197 women and 183 men) were found to be anemic.
483 anemic blood samples were selected for testing.
32 out of 483 were found positive for IgA anti-endomysial antibodies.
Microcytic anaemia was found in all but 3 of the 32 seropositive cases.
25 out of the 32 cases agreed to have endoscopic small bowel biopsies. 22 out of 25 (88%) of these had the typical histological appearances of celiac disease.
21 out of 22 cases were women. None of these women had previously been investigated for the possibility of celiac disease.
The authors found that, by selecting anemic subjects for screening, there was an improved detection rate (over 6%), compared with non-anemic volunteers (0%).
|6% of patients with iron deficiency anemia had celiac disease.|
|British Journal of Haematology|
Dr D. J. Unsworth, Consultant Immunologist at Southmead Hospital, concluded, "We show that, especially in anemic menstruating women, celiac disease is unrecognized and under-investigated."