Celiac disease presenting as iron-deficiency anemia in northern India.
BACKGROUND
Adult celiac disease is infrequent in India. Iron-deficiency anemia as its presenting manifestation is still rarer.


METHODS
We investigated patients with refractory iron-deficiency anemia attending the hematology clinic of a tertiary-care hospital for celiac disease. The diagnosis of celiac disease was based on histology, serology and response to treatment.


RESULTS
Of 19 patients with refractory iron-deficiency anemia seen from April 1998 to March 2000, 11 were diagnosed to have celiac disease. Four of these had abnormal D-xylose test and 3 had fat malabsorption. All 11 patients responded to gluten-free diet with improvement in hematological parameters.


CONCLUSIONS
Patients with refractory iron-deficiency anemia of unknown cause should be investigated for subclinical celiac disease.
Varma
S
S
Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh. svarma@cha.i91.net
Malhotra
P
P
Kochhar
R
R
Varma
N
N
Kumari
S
S
Jain
S
S
D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000175:diagnosis* / Q000453:epidemiology; D002446:Celiac Disease / Q000175:diagnosis* / Q000453:epidemiology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D008297:Male; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index