South Med J. 2004;97:30-34 03/30/2004 – According to Umaprasanna S. Karnam, MD (University of Miami School of Medicine in Florida), and colleagues, celiac disease is present in around 3% of iron-deficiency anemia cases. The researchers looked at all patients seen at the University of Miami for iron-deficiency anemia between 1998 and 2000. Iron-deficiency anemia was defined in their study as serum ferritin less than 25 ng/mL and hemoglobin less than 12 g/dL for women and less than 14 g/dL for men. Interestingly, patients with prior documented ulcerative or erosive conditions of the gastrointestinal tract or overt gastrointestinal bleeding during the prior three months were excluded (which means that many with advanced celiac disease would have been excluded from this study). Out of 139 possible patients with iron-deficiency anemia, 105 patients were included in the study (57 men and 48 women).

According to the researchers: The prevalence of occult celiac disease in this prospective study of patients presenting with iron-deficiency anemia was 2.8%. A significant number of other gastrointestinal lesions amenable to therapy were also found on upper and lower endoscopy in these patients, the authors write. Given the treatable nature of celiac disease, it should be screened for in patients with unexplained iron-deficiency anemia with or without hemoccult-positive stools. The investigators recommend panendoscopy and screening for this treatable condition in unexplained cases.

It is likely that had the study included patients with gastrointestinal bleeding or ulcerative conditions the rate of celiac disease would have been higher, perhaps as high as 5%.

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