Assessment of Iron Status and Iron Deficiency Anemia in Patients with Celiac Disease in Tripoli University Hospital

Abstract

Background: The iron absorption process occurs mainly in the proximal duodenum portion. this portion is typically destroyed in celiac disease (CD),resulting in a reduction in absorption of iron and subsequent iron deficiency anemia (IDA). IDA is the most common extraintestinal manifestation in CD. The primary treatment of CD is the gluten-free diet (GFD), which is associated with management of IDA, if present. Iron replacement treatment is mainly based on oral iron supplement. The absorption of iron is decreased in patients with untreated CD and unpredictable in patients on a GFD. Anemia Normalization is typically achieved after at least 6 months of GFD, but the process can take up to 2 years for iron stores to replenish. 

Aim: This study aimed to assess the status of iron stores and the frequency of iron deficiency anemia in Celiac disease (CD) patients referred to the Department of Gastroenterology, Tripoli University Hospital. 

Methods: In this study, 100 CD patients were assessed. The presence and severity of anaemia were determined using the serum hemoglobin concentration according to WHO criteria. The status of body iron stores was also evaluated based on serum ferritin levels.

Results: Mean and SD of age, serum iron, ferritin, TIBC, and serum hemoglobin were 27.98±9.42 years, 32.63± 24.76 μg/dL, 14.86±11.91mg/dL, 259.40±95.42 μg/dL and 10.26±2.54 g/dl, respectively. 38.0% had no anemia, 20.0% had mild anemia, 33.0% had moderate anemia, and 9.0% had severe anemia. 65.0% of patients had depleted iron stores, 35.0% had normal iron stores, and no exposure to iron overload.

Conclusion: In this study, 62.0% of CD patients on a gluten-free diet had some degree of anemia. In addition, 65.0% of patients had depleted iron stores.These results suggest that CD patients should be evaluated for iron status, even with a gluten-free diet.