Schmitz U, Ko Y, Seewald S, Düsing R, Vetter H
Medizinische Universitäts-Poliklinik, Bonn, Germany.
Clin Investig. 1994 Jul;72(7):519-21. doi: 10.1007/BF00207481.
We report on a 40-year-old woman with a 2-year history of iron-deficiency anemia of unknown origin. Repeated endoscopic investigations in the past had revealed no abnormality of the gastrointestinal system on macroscopic examination. Oral iron supplementation was shown to have no effect on serum iron levels and had no influence on the anemia. Upper gastrointestinal endoscopy performed at our hospital confirmed normal macroscopic findings. However, jejunal biopsies revealed subtotal villous atrophy of the mucosa of the small intestine. A strict gluten-free diet led to an increase in serum iron, resolution of the anemia, and restitution of normal mucosal architecture. Thus iron-deficiency anemia may be the lone manifestation of celiac disease.
我们报告了一名40岁女性，患有不明原因的缺铁性贫血2年。过去反复进行的内镜检查在宏观检查中未发现胃肠道系统异常。口服铁剂补充对血清铁水平无影响，对贫血也无作用。我院进行的上消化道内镜检查证实宏观检查结果正常。然而，空肠活检显示小肠黏膜出现部分绒毛萎缩。严格的无麸质饮食使血清铁升高，贫血得到缓解，黏膜结构恢复正常。因此，缺铁性贫血可能是乳糜泻的唯一表现。
