Improving detection of celiac disease patients: a prospective study in iron-deficient blood donors without anemia in north Italy.
OBJECTIVE
To evaluate the prevalence of celiac disease in asymptomatic iron-deficient blood donors without anemia.


METHODS
Between the period February 2004 and January 2006, iron-deficient male donors with serum ferritin less than 30 ng/ml and female donors with serum ferritin less than 10 ng/ml were screened for immunoglobulin A (IgA) and IgG antitissue transglutaminase antibodies and donors with positive antibody titers were referred for endoscopy with multiple biopsies of the second/third part of duodenum. The frequency of celiac disease in iron-deficient blood donors without anemia and the predictive value of ferritin levels were analyzed.


RESULTS
Of the 1679 blood donors, 579 (34.4%) were identified as iron deficient and screened for celiac disease. 290 (50%) were men (mean age: 39 years; range: 19-65) and 289 (50%) were women (mean age: 37 years; range: 19-63). Thirteen donors (2.2%) were positive for serum IgA antitissue transglutaminase antibodies, of whom six were men (2.0%) and seven were women (2.4%). 10 donors of 13 (1.7%) at histology presented alterations in the mucosal architecture according to the modified Marsh classification (Marsh I-III). Low ferritin level was not predictive for celiac disease (median serum ferritin level in celiac donors 14.7 ng/ml and in nonceliac donors 15.8 ng/ml, Wilcoxon test: P not significant). The prevalence of celiac disease among iron-deficient blood donors without anemia was 1.7%.


CONCLUSIONS
The prevalence of celiac disease in our population of asymptomatic iron-deficient blood donors without anemia was 1.7%. We suggest screening for celiac disease in iron-deficient individuals without anemia to increase diagnosis of asymptomatic celiac disease.
aDepartment of Gastroenterology bTranslational Research Department, Stem Cell Unit cDepartment of Translational Research, Faculty of Bioproteomic dDepartment of Pathology, Centro di Riferimento Oncologico, National Cancer Institute, IRCCS, Aviano (PN), Italy.
Renato
R
Cannizzaro
Alessandro
A
Da Ponte
Maria
M
Tabuso
Mario
M
Mazzucato
Valli
V
De Re
Laura
L
Caggiari
Mara
M
Fornasarig
Stefania
S
Maiero
Enrico
E
Orzes
Vincenzo
V
Canzonieri
D000328:Adult; D000368:Aged; D018798:Anemia, Iron-Deficiency; D058070:Asymptomatic Diseases / Q000453:epidemiology*; D001323:Autoantibodies / Q000097:blood; D001782:Blood Donors / Q000706:statistics & numerical data*; D002446:Celiac Disease / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D005293:Ferritins / Q000097:blood; D019204:GTP-Binding Proteins / Q000276:immunology; D006801:Humans; D000090463:Iron Deficiencies; D007558:Italy / Q000453:epidemiology; D008297:Male; D013058:Mass Spectrometry; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D016036:Seroepidemiologic Studies; D011503:Transglutaminases / Q000276:immunology; D055815:Young Adult
D001323:Autoantibodies; D005293:Ferritins; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases; D019204:GTP-Binding Proteins