A prospective study of the prevalence of undiagnosed coeliac disease in laboratory defined iron and folate deficiency

Abstract

Aims: To determine the prevalence of coeliac disease in a group of patients in the community who have been shown in the laboratory to have iron and/or folate deficiency. To assess the cost efficiency of this laboratory based case finding strategy. Methods: The study was undertaken in a large general hospital in the UK serving a population of 300 000. Three hundred and thirty three eligible patients with iron and/or folate deficiency were identified and contacted over an 18 month period. Case finding was by testing for coeliac disease using serological methods and subsequent histological confirmation. Results: Of the 333 eligible and contactable patients with iron and/or folate deficiency, 258 (77%) consented to coeliac disease antibody testing. Twenty eight patients (10.9%) were positive for coeliac disease antibodies. Of these, 24 patients proceeded to endoscopy and biopsy, resulting in 12 cases of histologically confirmed coeliac disease (4.7% (95% confidence interval, 2.1% to 6.8%) of patients tested for coeliac disease antibodies). Conclusions: This laboratory based methodology detected a considerable number of new coeliac disease cases in the community. Many of these patients did not present with clinical findings suggestive of malabsorption and might not otherwise have been diagnosed. Laboratory based methodologies should be considered in conjunction with other strategies for the early identification and treatment of coeliac disease.

Celiac disease prevalence in patients with iron deficiency anemia of obscure origin

“…Anemia, especially IDA, is a frequent feature in CD and may be the only presenting symptom (2). Increased prevalence of CD has been found in patients with IDA (16,17). An early identification of CD in patients with IDA has great importance, since a strict adherence to a gluten-free diet not only provides management of anemia but also prevents the severe complications such as ulcerative jejunoileitis, intestinal lymphoma and neoplasm (20).…”

“…Only a minority of CD patients present with classical malabsorption symptoms, whereas most patients have subclinical or silent forms in which IDA can be the sole presentation (15). The prevalence of CD was found between 4.7-5% in patients with IDA (16,17).…”

The Prevalence and Clinico-Epidemiological Profile of Celiac Disease in Anaemic Children Admitted At a Tertiary Care Hospital of North West Rajasthan (India)

“…In a study by Unsworth et al prevalence of celiac disease in anemic children was reported 6.6% [20] .Similarly in another study by Howard et al ,the prevalence of Celiac disease in anemic patient was found 10.9% while Annibale et al reported 13.7% prevalence of Celiac disease in anemic children [21], [22]. In another study by Grisolano et al, 103 anemic patients were screened by duodenal biopsy and 8.7% were found positive on biopsy [15] .…”

Clinical and Laboratory Features and Extraintestinal Manifestations of Celiac Disease in Adults

“…Çoğu hastada, endoskopik olarak duodenumda başta mukozal kıvrımlarda azalma, daha az duyarlılıkla da mozaik patern, nodülarite ve tarak şeklinde [6]. Ancak bunlar içerisinde iki çalışmada pozitif seroloji ve duoneal biyopsi ile kanıtlanmış çölyak hastalığı prevalansı % 2,3 ve % 4,7 olarak bildirilmiştir [7,8]. Bizim çalışmamızda da bu literatürler ile uyumlu olarak sadece 1 hastada (% 4,5) tipik semptom ve birlikte vitamin B12 veya folat eksikliği olmadan sadece demir eksikliği anemisi nedeniyle araştırılırken çölyak hastalığı tanısı konulduğu tespit edildi.…”