Hematologic Manifestation of Childhood Celiac Disease

Abstract

We wanted to describe the hematologic manifestations of celiac disease (CD) in childhood. This study included 22 children with CD in whom the disease remained undiagnosed until they had presented with hematological abnormalities, such as anemia, thrombocytopenia, leukopenia or prolonged prothrombin time (PT) and activated partial thromboplastin time (APTT). Anemia was present alone in 19 (86.3%) patients, and leukopenia coexisted with anemia in 2 (9%) patients. Thrombocytopenia was found alone in 1 (4.5%) patient. Twelve patients had an iron deficiency anemia. Iron deficiency coexisted with zinc and vitamin B₁₂ deficiency in 3 patients, copper and vitamin B₁₂ deficiency in two, vitamin B₁₂ deficiency in two, zinc deficiency in two and one patient had combined iron, zinc, and copper deficiency. Males had significantly lower values of hemoglobin (p < 0.05) and MCV (p < 0.05) compared to the females. In conclusion CD should be included in the differential diagnosis in children who present with anemia, leukopenia, thrombocytopenia or prolonged PT and APTT, especially in geographical areas where the prevalence of the CD is high.

Hematologic manifestations of celiac disease

“…Copper deficiency has been described in adults and children with CD and may result in anemia and thrombocytopenia. [69][70][71][72] We have recently diagnosed adult CD patients with symptomatic copper deficiency (T.R.H. and J.A.M., unpublished data, October 2006).…”

“…[72][73][74][75][76][77] Thrombocytopenia associated with CD has been reported in association with keratoconjunctivitis and choroidopathy, suggesting an autoimmune pathophysiology. 73,74 The best therapy for thrombocytopenia in association with CD is uncertain, given the rarity of the problem, but a GFD may result in normalization of the platelet count in some cases.…”

“…73,74 The best therapy for thrombocytopenia in association with CD is uncertain, given the rarity of the problem, but a GFD may result in normalization of the platelet count in some cases. 72 Thrombocytosis in association with CD appears to be more common than thrombocytopenia, occurring in up to 60% of patients. [78][79][80][81] The exact etiology of the thrombocytosis is unknown but it may be secondary to inflammatory mediators or, in some cases, secondary to iron-deficiency anemia or functional hyposplenia.…”

The hematologic manifestations of pediatric celiac disease at the time ofdiagnosis and efficiency of gluten-free diet

“…Thrombocytopenia rarely develops in CD and is generally a result of autoimmune mechanisms (25)(26)(27). Thrombocytosis is more commonly seen than thrombocytopenia with a prevalence of up to 60% in CD patients (11,28,29).…”

Rare Association of Coeliac Disease with Aplastic Anaemia: Report of a Case from India

“…There are some case reports of anaemia with severe thrombocytopenia [4], and pancytopenia [5] in CD. Cause of pancytopenia in CD is multifactorial.…”