Abstract

PONTET, Yéssica  and  OLANO, Carolina. Anemia in celiac disease. Gen [online]. 2021, vol.75, n.2, pp.66-70.  Epub Oct 24, 2021. ISSN 0016-3503.

In adults, anemia is a common manifestation of celiac disease. Therefore, the mere presence of anemia makes the active search for this pathology imperative. The cause of anemia in celiac disease is multifactorial, iron deficiency is the most frequent. This deficiency can be explained by malabsorption, inadequate iron intake, intestinal micro bleeding and by desquamation of the intestinal epithelium. In general, it does not respond to oral supplementation but to the gluten-free diet. Folic acid deficiency is also frequent, as it shares with iron the absorption site. In patients under a gluten-free diet, the deficiency can be perpetuated if supplemented flours are not considered. Ileal involvement causing vitamin B12 deficiency is not common but lowers levels can be found, due to bacterial overgrowth or acid secretion disorders. Inflammatory anemia is also a cause to consider as in any chronic disease. It occurs with the inhibition of erythropoietin due to a pro-inflammatory state and increased levels of ferritin and hepcidin. In all cases, compliance with a gluten-free diet is essential. In a celiac patient who complies with the diet and persists with anemia after a considerable period, a refractory or complicated disease must be considered. Otherwise, it forces to look for independent differentials.

Keywords : celiac disease; anemia; iron deficiency.

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