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Anemia in celiac disease is multifactorial in etiology.
Am J Hematol. 2007 Nov; 82(11):996-1000.AJ

Abstract

Anemia in celiac disease (CD) has been attributed to nutritional deficiencies; however, the clinical manifestations of CD have changed with nongastrointestinal presentations predominating. We collected hematologic parameters from a cohort of patients seen at a tertiary care center for CD to assess the characteristics of anemia in this population. Hematological parameters measured <or=3 months of diagnosis and degree of villous atrophy from 405 patients diagnosed >1995 was analyzed. Ferritin levels were compared with population controls (NHANES III). Iron deficiency was common, occurring in 33% of men and 19% of women (P < 0.001). Folate deficiency was seen in approximately 12% of the total sample and B12 deficiency in approximately 5%. Anemia was present in approximately 20% of the cohort. Among the anemic patients, ferritin was less than the 10th percentile in 45%, between the 10th and 50th percentile in 39% and greater than the 50th percentile in 13%. Ferritin > 50th percentile was more common in anemic men (24%) than in anemic women (9%; P > 0.20). Macrocytic anemia with concurrent B12 or folate deficiency was rare (3%). Elevated ESR was observed in patients with ferritin < 10th percentile and >50th. A gluten-free diet resulted in increased serum ferritin in iron-deficient patients, and decreased ferritin levels in those with high ferritin (r(2) = 0.46, P < 0.001). Although anemia is still a common presentation of celiac disease, nutritional deficiencies alone do not explain this phenomenon in all cases; inflammation appears to contribute as evidenced by the presence of anemia of chronic disease in some individuals.

Authors+Show Affiliations

Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York 10032, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17636474

Citation

Harper, Jason W., et al. "Anemia in Celiac Disease Is Multifactorial in Etiology." American Journal of Hematology, vol. 82, no. 11, 2007, pp. 996-1000.
Harper JW, Holleran SF, Ramakrishnan R, et al. Anemia in celiac disease is multifactorial in etiology. Am J Hematol. 2007;82(11):996-1000.
Harper, J. W., Holleran, S. F., Ramakrishnan, R., Bhagat, G., & Green, P. H. (2007). Anemia in celiac disease is multifactorial in etiology. American Journal of Hematology, 82(11), 996-1000.
Harper JW, et al. Anemia in Celiac Disease Is Multifactorial in Etiology. Am J Hematol. 2007;82(11):996-1000. PubMed PMID: 17636474.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Anemia in celiac disease is multifactorial in etiology. AU - Harper,Jason W, AU - Holleran,Stephen F, AU - Ramakrishnan,Rajasehkar, AU - Bhagat,Govind, AU - Green,Peter H R, PY - 2007/7/20/pubmed PY - 2007/12/6/medline PY - 2007/7/20/entrez SP - 996 EP - 1000 JF - American journal of hematology JO - Am J Hematol VL - 82 IS - 11 N2 - Anemia in celiac disease (CD) has been attributed to nutritional deficiencies; however, the clinical manifestations of CD have changed with nongastrointestinal presentations predominating. We collected hematologic parameters from a cohort of patients seen at a tertiary care center for CD to assess the characteristics of anemia in this population. Hematological parameters measured <or=3 months of diagnosis and degree of villous atrophy from 405 patients diagnosed >1995 was analyzed. Ferritin levels were compared with population controls (NHANES III). Iron deficiency was common, occurring in 33% of men and 19% of women (P < 0.001). Folate deficiency was seen in approximately 12% of the total sample and B12 deficiency in approximately 5%. Anemia was present in approximately 20% of the cohort. Among the anemic patients, ferritin was less than the 10th percentile in 45%, between the 10th and 50th percentile in 39% and greater than the 50th percentile in 13%. Ferritin > 50th percentile was more common in anemic men (24%) than in anemic women (9%; P > 0.20). Macrocytic anemia with concurrent B12 or folate deficiency was rare (3%). Elevated ESR was observed in patients with ferritin < 10th percentile and >50th. A gluten-free diet resulted in increased serum ferritin in iron-deficient patients, and decreased ferritin levels in those with high ferritin (r(2) = 0.46, P < 0.001). Although anemia is still a common presentation of celiac disease, nutritional deficiencies alone do not explain this phenomenon in all cases; inflammation appears to contribute as evidenced by the presence of anemia of chronic disease in some individuals. SN - 0361-8609 UR - https://www.unboundmedicine.com/medline/citation/17636474/Anemia_in_celiac_disease_is_multifactorial_in_etiology_ L2 - https://doi.org/10.1002/ajh.20996 DB - PRIME DP - Unbound Medicine ER -