title: The prevalence of celiac disease in children with iron-deficiency anemia.
abstract: OBJECTIVE
  Celiac disease is an immune-mediated enteropathy caused by a permanent sensitivity to gluten in genetically susceptible individuals. Iron-deficiency anemia is the most commonly encountered anemia in humans. Iron-deficiency anemia also is a common extraintestinal manifestation of celiac disease. To determine the celiac disease prevalence in children with iron-deficiency anemia and to compare the hematologic parameters in iron-deficiency anemia patients with and without celiac disease.
  
  
  METHODS
  A total of 61 patients aged 2-16 years who presented with iron-deficiency anemia were included in this study. Hemoglobin, red cell indices (mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, red cell distribution width), serum iron, and serum ferritin were determined. Venous blood samples for anti-tissue transglutaminase antibody immunoglobuline A were obtained from these patients. Upper gastrointestinal endoscopy was recommended to patients who had positive serology.
  
  
  RESULTS
  Of 61 patients with iron-deficiency anemia, 13 (21,3%) had positive serology for celiac disease. The small intestine biopsy of all patients with positive serology showed villous atrophy (Marsh 3). The mean hemoglobin level was significantly lower in iron-deficiency anemia patients with celiac disease when compared to those without celiac disease (7,8±2,6 vs. 11,3±0,9 g/dL, p>0,05). There was a statistically significant negative correlation of tissue transglutaminase titers with hemoglobin, red cell indices, serum iron, and serum ferritin levels.
  
  
  CONCLUSIONS
  Screening of celiac disease by anti-tissue transglutaminase antibody should be done as a routine investigation in children with iron-deficiency anemia. Biopsy should be recommended in patients with iron-deficiency anemia who have positive celiac disease serology.
authors.affiliation: Atatürk University Faculty of Medicine, Department of Pediatric Gastroenterology, Hepatology and Nutrition, Erzurum, Turkey.
authors.forename: Vildan
authors.initials: V
authors.lastname: Ertekin
authors.forename: Mahya Sultan
authors.initials: MS
authors.lastname: Tozun
authors.forename: Nuran
authors.initials: N
authors.lastname: Küçük
mesh_terms: D000293:Adolescent; D018798:Anemia, Iron-Deficiency / Q000097:blood* / Q000453:epidemiology*; D002446:Celiac Disease / Q000097:blood* / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D004909:Erythrocyte Indices; D005260:Female; D005293:Ferritins / Q000097:blood; D019204:GTP-Binding Proteins / Q000276:immunology; D006400:Hematocrit; D006454:Hemoglobins; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007501:Iron / Q000097:blood; D008297:Male; D015995:Prevalence; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases / Q000276:immunology
chemical_list: D006454:Hemoglobins; D007070:Immunoglobulin A; D005293:Ferritins; D007501:Iron; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases; D019204:GTP-Binding Proteins