Hematological manifestations of celiac disease

Abstract

Celiac disease, an autoimmune disease once thought to be uncommon, is now being increasingly identified. Our improved diagnostic modalities have allowed us to diagnose more and more patients with atypical symptoms who improve on gluten-free diet (GFD). We discuss here the latest findings regarding the various hematological manifestations of celiac disease and their management. Anemia remains the most common hematological manifestation of celiac disease due to many mechanisms, and can be the sole presenting symptom. Other manifestations include thrombocytosis and thrombocythemia, leukopenia, thromboembolism, increased bleeding tendency, IgA deficiency, splenic dysfunction, and lymphoma. The diagnosis of celiac disease should always be kept in mind when a patient presents with unexplained and isolated hematological finding. Once diagnosed, patients should adhere to GFD and be educated about the potential complications of this disease. We herein present an algorithm for adequate management and follow-up.

Diagnostic accuracy of red blood cell distribution width-to-lymphocyte ratio for celiac disease

“…This would allow greater number of patients to be correctly selected for further specific testing. Hematologic changes are common in CD patients (5,6), but they are not frequently reported in current guidelines (3,7,8). These changes in routine laboratory workup results can be subtle, but at the same time they can be the only sign of disease in some of the patients.…”

Clinical Manifestations of Celiac Disease

“…Anemia was the second most frequent presentation in our series and the most common hematologic manifestation of CD [16]. The anemia in CD is multifactorial in etiology with both iron deficiency and anemia of chronic disease predominating [17].…”

Prevalence of occult celiac disease in females with iron deficiency in the United States: an NHANES analysis

“…This is explained by the fact that CD is one of the causes leading to ID. Correspondingly, ID and anemia are very common laboratory abnormalities in CD [31,32]. ID can occur with or without the occurrence of diarrhea or steatorrhea in CD as iron is lost in the form of sloughed intestinal enterocytes or gastrointestinal bleeding or due to malabsorption of dietary iron [33,34].…”