title: Celiac disease prevalence in patients with iron deficiency anemia.
abstract: OBJECTIVE
  Iron deficiency anemia may be the first presenting finding of celiac disease, which is a common autoimmune disorder triggered by the intake of certain proteins. The aim of this study was to determine the prevalence of celiac disease in patients with iron deficiency anemia of obscure origin.
  
  
  METHODS
  Eighty-four patients with the diagnosis of iron deficiency anemia of obscure origin were included in the study. Histologic findings for celiac disease were investigated in biopsy specimens taken from the second part of the duodenum of all subjects. Patients were also screened using anti-endomysial and anti-gliadin antibodies. The diagnosis of celiac disease was confirmed by both serological positivity and histopathological findings.
  
  
  RESULTS
  In 6 of 84 patients (7.14%), both serologic and histopathologic findings were correlated with celiac disease. After six months under a gluten-free diet, their mean hemoglobin levels increased from 10.3 ± 0.64 to 12.97 ± 1.48 g/dl (p=0.002). One patient with positive serology for celiac disease but normal duodenal mucosal biopsies also improved clinically after a gluten-free diet at the end of the follow-up and was considered as celiac disease. Six of these 7 celiac disease patients (85.7%) were premenopausal women, with a mean age of 37.5 ± 8.45 years.
  
  
  CONCLUSIONS
  Clinicians should consider celiac disease as a possible cause of anemia in all patients with iron deficiency anemia of obscure origin, even in menstruating women. Serologic screening tests should be performed in premenopausal women with iron deficiency anemia, especially when anemia is refractory to oral iron treatment.
authors.affiliation: Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey. ayhancekin@hotmail.com
authors.forename: Ayhan Hilmi
authors.initials: AH
authors.lastname: Çekın
authors.forename: Yeşim
authors.initials: Y
authors.lastname: Çekın
authors.forename: Cem
authors.initials: C
authors.lastname: Sezer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018798:Anemia, Iron-Deficiency / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D000888:Antibodies, Anti-Idiotypic / Q000032:analysis; D001706:Biopsy; D002446:Celiac Disease / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000276:immunology; D007413:Intestinal Mucosa / Q000276:immunology / Q000473:pathology; D007421:Intestine, Small / Q000276:immunology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000888:Antibodies, Anti-Idiotypic; D007070:Immunoglobulin A