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 25 May 2018

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News

Celiac disease is under-diagnosed in anemic subjects

Improving the diagnosis of celiac disease in anemic women.

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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.

6% of patients with iron deficiency anemia had celiac disease.
British Journal of Haematology
The authors found that, by selecting anemic subjects for screening, there was an improved detection rate (over 6%), compared with non-anemic volunteers (0%).

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."

Br J Haematol 2000; 111 (3): 898-901
08 February 2001

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