International Journal of Celiac Disease
ISSN (Print): 2334-3427 ISSN (Online): 2334-3486 Website: http://www.sciepub.com/journal/ijcd Editor-in-chief: Samasca Gabriel
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International Journal of Celiac Disease. 2018, 6(1), 26-29
DOI: 10.12691/ijcd-6-1-2
Open AccessSpecial Issue

Iron refractory or Iron Resistant Iron Deficiency Anemia in Adult Celiac Disease Resolves with a Gluten-free Diet

Hugh James Freeman1,

1Department of Medicine (Gastroenterology), University of British Columbia, Vancouver, Canada

Pub. Date: April 02, 2018

Cite this paper:
Hugh James Freeman. Iron refractory or Iron Resistant Iron Deficiency Anemia in Adult Celiac Disease Resolves with a Gluten-free Diet. International Journal of Celiac Disease. 2018; 6(1):26-29. doi: 10.12691/ijcd-6-1-2

Abstract

Iron deficiency anemia is a common presentation of adult celiac disease. In a retrospective review of over 200 adults with celiac disease complicated by iron deficiency anemia, 7 patients were selected that were treated either with oral iron supplements with a limited hematologic response or unable to tolerate oral iron. Subsequently, treatment with a strict gluten free diet alone was provided. In all, resolution of the anemia resulted without a need for concomitant oral iron supplements. Another patient with marked fatigue and exercise intolerance was treated with intravenous iron, but the iron deficiency anemia only partially improved. After a strict gluten-free diet, her iron deficiency anemia resolved completely. Clinical experience in these celiac patients indicates that the key element in the treatment of iron deficiency anemia is a positive intestinal mucosal response to a gluten-free diet. In celiac patients with iron deficiency anemia, particularly with a limited hematologic response, intolerance or side effects to iron supplements, treatment solely with a gluten-free diet may be a reasonable option. Iron deficiency anemia in celiac disease is heterogeneous and may have multiple causes. Although duodenal mucosal disease is a critical factor, other factors may alter the regulation of iron homeostasis in this setting, including altered erythropoiesis due to the underlying chronic intestinal inflammatory process.

Keywords:
adult celiac disease iron deficiency anemia iron refractory anemia gluten-free diet

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