Berry Neha, Basha Jahangeer, Varma Neelam, Varma Subhash, Prasad Kaushal Kishor, Vaiphei Kim, Dhaka Narendra, Sinha Saroj K, Kochhar Rakesh
Department of Gastroenterology Postgraduate Institute of Medical Education and Research Chandigarh India.
Department of Hematopathology Postgraduate Institute of Medical Education and Research Chandigarh India.
JGH Open. 2018 Aug 2;2(5):196-200. doi: 10.1002/jgh3.12073. eCollection 2018 Oct.
Anemia is one of the most common extraintestinal manifestations of celiac disease (CD), with iron deficiency anemia (IDA) being the predominant cause. However, anemia in CD can have varied etiologies, including mixed nutritional deficiency. We aimed to study the prevalence and etiology of anemia in CD in a north Indian population.
In this prospective observational study, consecutive patients with documented CD between January 2012 and December 2013 were included, and all patients underwent detailed clinical assessment; hematological investigations including iron profile, serum folate, and vitamin B levels; and esophageoduodenoscopy with duodenal biopsies for histopathological examination. Prevalence of anemia and different deficiencies were calculated, and a correlation between hematological parameters and histological findings was found.
Of the 103 patients studied, anemia was detected in 96 patients, giving a prevalence of 93.2% with a baseline hemoglobin of 8.94 ± 2.54 g/dL. Overall, iron deficiency was seen in 84 (81.5%) patients, followed by vitamin B deficiency in 14 (13.6%) and folate deficiency in 11 (10.7%) patients; 17 (16.5%) patients had anemia due to mixed nutritional deficiencies, and 4 (3.9%) patients had anemia of chronic disease. The mean hemoglobin and median ferritin levels were significantly lower in patients with severe villous atrophy compared to those with mild atrophy.
Anemia in patients with CD is multifactorial. Even though iron deficiency is the most common cause, other nutrient deficiencies should always be explored.
贫血是乳糜泻（CD）最常见的肠外表现之一，缺铁性贫血（IDA）是主要原因。然而，CD患者的贫血病因可能多种多样，包括混合性营养缺乏。我们旨在研究印度北部人群中CD患者贫血的患病率及病因。
在这项前瞻性观察性研究中，纳入了2012年1月至2013年12月期间确诊为CD的连续患者，所有患者均接受了详细的临床评估；血液学检查，包括铁代谢指标、血清叶酸和维生素B水平；以及食管十二指肠镜检查并取十二指肠活检进行组织病理学检查。计算贫血和不同缺乏症的患病率，并分析血液学参数与组织学结果之间的相关性。
在研究的103例患者中，96例检测到贫血，患病率为93.2%，基线血红蛋白水平为8.94±2.54g/dL。总体而言，84例（81.5%）患者存在缺铁，其次是14例（13.6%）患者存在维生素B缺乏，11例（10.7%）患者存在叶酸缺乏；17例（16.5%）患者因混合性营养缺乏导致贫血，4例（3.9%）患者患有慢性病贫血。与轻度绒毛萎缩患者相比，重度绒毛萎缩患者的平均血红蛋白和中位铁蛋白水平显著降低。
CD患者的贫血是多因素的。尽管缺铁是最常见的原因，但也应始终探索其他营养素缺乏情况。
