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Mild enteropathy as a cause of iron-deficiency anaemia of previously unknown origin.
Dig Liver Dis. 2011 Jun; 43(6):448-53.DL

Abstract

BACKGROUND AND AIMS

We assessed whether mild enteropathy with negative coeliac serology may be gluten-dependent, and a cause of iron-deficiency anaemia. In cases not responding to gluten-free diet, the role of Helicobacter pylori infection was evaluated.

METHODS

55 consecutive unexplained iron-deficiency anaemia patients were included. In all of them we performed: HLA-DQ2/DQ8 coeliac genetic study, distal duodenum biopsies, and tests to assess H. pylori infection. A gluten-free diet or H. pylori eradication was used as indicated. Final diagnosis was established based on response to specific therapy after a 12-month follow-up period.

RESULTS

Histological findings were: (1) group A (positive genetics): 21 Marsh I, 2 Marsh IIIA, 12 normal; (2) group B (negative genetics): 16 Marsh I, 4 normal. Final diagnosis of anaemia in patients with enteropathy were: group A, gluten-sensitive enteropathy, 45%; H. pylori infection, 20%; gluten-sensitive enteropathy plus H. pylori, 10%; other, 10%; unknown, 15%; group B, gluten-sensitive enteropathy, 10%; H. pylori infection, 0% (1 non-eradicated case, 10%); non-steroidal anti-inflammatory drug intake, 20%; other, 20%; unknown, 40% (p=0.033).

CONCLUSIONS

Mild enteropathy is frequent in patients with unexplained iron-deficiency anaemia and negative coeliac serology. Most cases are secondary to either gluten-sensitive enteropathy or H. pylori infection, or both; however, there is also a substantial number of patients without a definitive diagnosis.

Authors+Show Affiliations

Department of Gastroenterology, Hospital Universitari Mútua Terrassa and Research Foundation Mútua Terrassa, Barcelona, Spain.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo 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

21233030

Citation

Monzón, Helena, et al. "Mild Enteropathy as a Cause of Iron-deficiency Anaemia of Previously Unknown Origin." Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, vol. 43, no. 6, 2011, pp. 448-53.
Monzón H, Forné M, González C, et al. Mild enteropathy as a cause of iron-deficiency anaemia of previously unknown origin. Dig Liver Dis. 2011;43(6):448-53.
Monzón, H., Forné, M., González, C., Esteve, M., Martí, J. M., Rosinach, M., Mariné, M., Loras, C., Espinós, J. C., Salas, A., Viver, J. M., & Fernández-Bañares, F. (2011). Mild enteropathy as a cause of iron-deficiency anaemia of previously unknown origin. Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, 43(6), 448-53. https://doi.org/10.1016/j.dld.2010.12.003
Monzón H, et al. Mild Enteropathy as a Cause of Iron-deficiency Anaemia of Previously Unknown Origin. Dig Liver Dis. 2011;43(6):448-53. PubMed PMID: 21233030.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mild enteropathy as a cause of iron-deficiency anaemia of previously unknown origin. AU - Monzón,Helena, AU - Forné,Monserrat, AU - González,Clarisa, AU - Esteve,Maria, AU - Martí,Josep M, AU - Rosinach,Mercè, AU - Mariné,Meritxell, AU - Loras,Carme, AU - Espinós,Jorge C, AU - Salas,Antonio, AU - Viver,Josep M, AU - Fernández-Bañares,Fernando, Y1 - 2011/01/12/ PY - 2010/09/20/received PY - 2010/11/04/revised PY - 2010/12/02/accepted PY - 2011/1/15/entrez PY - 2011/1/15/pubmed PY - 2011/10/7/medline SP - 448 EP - 53 JF - Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver JO - Dig Liver Dis VL - 43 IS - 6 N2 - BACKGROUND AND AIMS: We assessed whether mild enteropathy with negative coeliac serology may be gluten-dependent, and a cause of iron-deficiency anaemia. In cases not responding to gluten-free diet, the role of Helicobacter pylori infection was evaluated. METHODS: 55 consecutive unexplained iron-deficiency anaemia patients were included. In all of them we performed: HLA-DQ2/DQ8 coeliac genetic study, distal duodenum biopsies, and tests to assess H. pylori infection. A gluten-free diet or H. pylori eradication was used as indicated. Final diagnosis was established based on response to specific therapy after a 12-month follow-up period. RESULTS: Histological findings were: (1) group A (positive genetics): 21 Marsh I, 2 Marsh IIIA, 12 normal; (2) group B (negative genetics): 16 Marsh I, 4 normal. Final diagnosis of anaemia in patients with enteropathy were: group A, gluten-sensitive enteropathy, 45%; H. pylori infection, 20%; gluten-sensitive enteropathy plus H. pylori, 10%; other, 10%; unknown, 15%; group B, gluten-sensitive enteropathy, 10%; H. pylori infection, 0% (1 non-eradicated case, 10%); non-steroidal anti-inflammatory drug intake, 20%; other, 20%; unknown, 40% (p=0.033). CONCLUSIONS: Mild enteropathy is frequent in patients with unexplained iron-deficiency anaemia and negative coeliac serology. Most cases are secondary to either gluten-sensitive enteropathy or H. pylori infection, or both; however, there is also a substantial number of patients without a definitive diagnosis. SN - 1878-3562 UR - https://www.unboundmedicine.com/medline/citation/21233030/Mild_enteropathy_as_a_cause_of_iron_deficiency_anaemia_of_previously_unknown_origin_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1590-8658(10)00393-2 DB - PRIME DP - Unbound Medicine ER -