Unawareness of gastrointestinal symptomatology in adult coeliac patients with unexplained iron-deficiency anaemia presentation.
BACKGROUND
Most adults with coeliac disease have a subclinical form of the disease and iron-deficiency anaemia may be the sole presenting symptom.


OBJECTIVE
To evaluate demographic, clinical and biochemical characteristics of adult coeliac disease patients presenting with iron-deficiency anaemia.


METHODS
A total of 108 iron-deficiency anaemia patients in whom coeliac disease has been diagnosed were studied. As a control group 108 non-coeliac iron-deficiency anaemia patients, comparable for sex and age, were studied.


RESULTS
Of the 108 coeliac disease patients, 95 (88%) were female (mean age 34 years, range 19-72) and 13 (12%) were male (mean age 33 years, range 15-65). The median duration of iron-deficiency anaemia before diagnosis was 66 months in coeliac disease patients and 14 months in the iron-deficiency anaemia control group (P = 0.0001). The occurrence of at least one gastrointestinal symptom, not spontaneously reported, was observed in 92 (85%) patients with coeliac disease and in 67 (62%) patients in the control group (P = 0.001). The concomitant presence of diarrhoea, abdominal pain and abdominal bloating was detected in 14% patients with coeliac disease with respect to 3% in the control group (P = 0.005).


CONCLUSIONS
The vast majority of coeliac disease patients with iron-deficiency anaemia presentation were unaware of the gastrointestinal symptoms and this relationship is useful for diet compliance.
Digestive and Liver Disease Unit, University La Sapienza, Rome, Italy.
F
F
Baccini
M A Aloe
MA
Spiriti
L
L
Vannella
B
B
Monarca
G
G
Delle Fave
B
B
Annibale
D000005:Abdomen / Q000503:physiopathology; D015746:Abdominal Pain / Q000209:etiology; D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018798:Anemia, Iron-Deficiency / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D002446:Celiac Disease / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D003967:Diarrhea / Q000209:etiology; D004386:Duodenum / Q000473:pathology; D016099:Endoscopy, Gastrointestinal / Q000379:methods; D005260:Female; D016481:Helicobacter Infections / Q000150:complications; D016480:Helicobacter pylori; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D007501:Iron / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D011706:Pyloric Antrum / Q000473:pathology
D006454:Hemoglobins; D007501:Iron