Evaluation of adult celiac disease from a tertiary reference center: a retrospective analysis

Binicier, Ömer Burçak; Tosun, Ferahnaz

doi:10.1590/1806-9282.66.1.55

Cited by 10 publications

(5 citation statements)

References 23 publications

(24 reference statements)

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“…A recent Turkish retrospective analysis of 195 adult patients at the time of CD diagnosis showed that anemia was found in 60.5% of patients (IDA in 53.3% of cases, folic acid deficiency in 38.4% of cases, vitamin B 12 deficiency in 25.6% of cases, and ACD in 10.2% of cases) [ 37 ]. In an Italian multicenter study including 1026 patients with subclinical/silent CD, IDA was the most frequent extra-intestinal sign (39%) in this CD subtype, being found in 46% of adult CD patients and 35% of pediatric CD patients [ 38 ].…”

Section: Resultsmentioning

confidence: 99%

Persistent Iron Deficiency Anemia in Patients with Celiac Disease Despite a Gluten-Free Diet

et al. 2020

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Celiac disease (CD) is an autoimmune disorder characterized by intolerance to dietary gluten in genetically predisposed subjects. Iron deficiency anemia (IDA) is a common sign in CD, being the only abnormality in approximately 40% of celiac patients. A multifactorial etiology leads to IDA in CD. The two main causes are the villous atrophy of the mucosa at the site of iron absorption (the duodenum) and the resulting inflammation, which triggers the mechanism that leads to the anemia of chronic disease. Until now, it has been unclear why some patients with CD continue to have IDA despite a careful gluten-free diet (GFD) and the normalization of villous atrophy. Furthermore, some celiac patients are refractory to oral iron supplementation despite the healing of the mucosa, and they thus require periodic intravenous iron administration. The Marsh classification evaluates the degree of inflammation and villous atrophy, but it does not assess the possible persistence of ultrastructural and molecular alterations in enterocytes. The latter was found in CD in remission after adopting a GFD and could be responsible for the persistently reduced absorption of iron and IDA. Even in non-celiac gluten sensitivity, anemia is present in 18.5–22% of patients and appears to be related to ultrastructural and molecular alterations in intestinal microvilli. It is possible that a genetic component may also play a role in IDA. In this review, we evaluate and discuss the main mechanisms of IDA in CD and the possible causes of its persistence after adopting a GFD, as well as their therapeutic implications.

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Section: Resultsmentioning

confidence: 99%

Persistent Iron Deficiency Anemia in Patients with Celiac Disease Despite a Gluten-Free Diet

et al. 2020

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“…The reported prevalence of anemia in previous studies differs among populations. European and US studies found a similar prevalence of anemia, ranging between 20% and 60.5% (8,9,11,14,24–28). However, 2 different Indian studies by Singh et al and Berry et al demonstrated a prevalence of 85%–93% of anemia in recently diagnosed CeD (10,19).…”

Section: Discussionmentioning

confidence: 86%

“…Anemia and micronutrient deficiencies are common in the setting of villous atrophy, especially in newly diagnosed adult patients with CeD (6,7). The reported prevalence of anemia in patients with CeD ranges between 20% and 93%, a percentage which varies by age, sex, and the studied CeD population (8)(9)(10)(11). Iron deficiency anemia (IDA) is the most common type of anemia and is due to iron malabsorption in the small intestinal mucosa (12).…”

Section: Introductionmentioning

confidence: 99%

Anemia Etiology and the Response to a Gluten-Free Diet in Untreated Patients With Celiac Disease: A 2-Year Follow-Up

et al. 2022

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INTRODUCTION:Anemia and micronutrient deficiencies are common in newly diagnosed patients with celiac disease (CeD). We aim to determine the prevalence and etiology of anemia in a cohort of patients with CeD in the United States and examine the effect of a gluten-free diet (GFD) on the laboratory parameters related to anemia in CeD.METHODS:We analyzed a prospectively collected cohort of adults with biopsy-proven CeD followed in a specialized CeD center between January 2000 and June 2016. We used the level of hemoglobin (Hb) and micronutrients suggested by the World Health Organization to establish the diagnosis of anemia or deficiencies. Demographic data and laboratory parameters related to anemia and micronutrients were recorded at the time of diagnosis and on a GFD. A celiac expert nutritionist or gastroenterologist evaluated all patients.RESULTS:In 572 patients with laboratory evaluation before starting a GFD, approximately 25% presented with anemia at the time of diagnosis of CeD. Iron deficiency was present in 50.8% of the cohort and in 78.8% of the patients with anemia. Within the anemic population, 84.4% of female patients as compared with 58.3% of male patients (P = 0.02) showed iron deficiency. Folate deficiency (23.2%), vitamin B12 deficiency (11%), and anemia of chronic diseases (7.8%) were also part of both sexes' anemia etiology. Of the initially anemic patients, 81% and 89% normalized their Hb levels within 1 year and 2 years of beginning a GFD, respectively. All patients received appropriate supplementation when needed.DISCUSSION:Approximately 25% of individuals have anemia at CeD diagnosis. The anemia etiology included iron deficiency, vitamin deficiencies, and anemia of chronic diseases. Most of the patients will normalize their Hb levels and the anemia laboratory parameters 1 year after starting a strict GFD.

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“…A detailed flow of the studies included in the meta‐analysis is shown in figure 1 (PRISMA figure). The details of the included studies are shown in Table 1 17–67 . Excluded studies with reason of exclusion are shown in Table S2.…”

Section: Resultsmentioning

confidence: 99%

Liver abnormalities in celiac disease and response to gluten free diet: A systematic review and meta‐analysis

Jena

Kumar‐M

Kumar

et al. 2022

J of Gastro and Hepatol

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Background and Aim Liver involvement in celiac disease (CeD) is known but its various etiologies and the effect of gluten free diet (GFD) on it is understudied. Methods We searched PubMed, Medline and Embase databases from date of inception to March 7, 2022, to look for studies reporting on CeD and liver abnormalities. Pooled proportion of CeD patients with deranged transaminases, etiologies of various other liver diseases with CeD and the response to GFD were estimated. Subgroup analyses based on the age group, geographic distribution and duration of GFD were also carried out. Results Total 42 studies (8976 patients) reported hyper‐transaminasemia in patients with celiac disease. The pooled proportion of patients with elevated transaminases was 21.42% (95% CI: 17.02–26.59, I2 = 94%) overall, with similar prevalence among adults (21.20%) and children (21.51%). The commonest etiology was celiac hepatitis at 49.23% (95% CI: 30.09–68.59, I2 = 87%). Compliance with GFD was noted in 90.27%. The proportion of CeD patients with liver abnormalities who showed response to GFD was 86.39% (95% CI: 80.04–90.95, I2 = 74%) overall. Conclusion Liver involvement was noted in 21.42% of CeD patients. Celiac hepatitis was reported in nearly half of them. Good compliance and response were noted with GFD.

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Evaluation of adult celiac disease from a tertiary reference center: a retrospective analysis

Cited by 10 publications

References 23 publications

Persistent Iron Deficiency Anemia in Patients with Celiac Disease Despite a Gluten-Free Diet

Persistent Iron Deficiency Anemia in Patients with Celiac Disease Despite a Gluten-Free Diet

Anemia Etiology and the Response to a Gluten-Free Diet in Untreated Patients With Celiac Disease: A 2-Year Follow-Up

Liver abnormalities in celiac disease and response to gluten free diet: A systematic review and meta‐analysis

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