Saturday, July 23, 2011

Refractory iron-deficiency anemia caused by gluten intolerance

Yet another clear piece of evidence of the problems of un-recognised and un-treated consequences of gluten sensitivity. When do you think that mainstream doctors are going to wake up to this diagnosis? Every week that they continue in "self-induced-disbelief", thousands of patients unnecessarily continue to suffer undiagnosed.

Here is the abstract:

Rev Esp Enferm Dig. 2011 Jul;103(7):349-354.
Refractory iron-deficiency anemia and gluten intolerance - Response to gluten-free diet.Rodrigo Sáez L, Fuentes Álvarez D, Pérez Martínez I, Alvarez Mieres N, Niño García P, De Francisco García R, Riestra Menéndez S, Vivas Alegre S, Olcoz Goñi JL.
ntroduction: refractory iron-deficiency anemia has a multifactorial origin related to various gastrointestinal conditions, with celiac disease plus malabsorption and IBD together with isolated gluten intolerance being most common.Objectives: to determine the prevalence of serum, genetic, and histological markers for gluten intolerance, and to analyze the response to gluten withdrawal from the diet in these patients.Methods: a number of patients with refractory anemia were prospectively and consecutively enrolled. A protocol to measure serum (TGt-2), genetic (HLA-DQ2/DQ8), and histological markers for celiac disease was applied. All followed a gluten-free diet for a median 3.6 years. Sustained remission of anemia during follow-up was interpreted as positive response.Results: ninety-eight patients (84% females) with a mean age of 54 years were studied. Anti-TGt2 antibodies were positive in 5% of cases. A total of 67 cases (68%) were haplotype HLA-DQ2 or -DQ8 (+). We found villous atrophy (Marsh III) in 13% of patients, and an inflammatory pattern (Marsh I or II) in 13%. All remaining 72 patients (74%) had no histological duodenal changes.Age, anemia duration, number of transfusions, number of parenteral iron doses, and time on a gluten-free diet were all compared according to the presence or absence of villous atrophy and HLA-DQ2/8 positivity, and no significant differences were found for any of the analyzed variables. Response was positive in 92% of subjects.Conclusions: celiac disease with villous atrophy is rarely a cause of refractory anemia. Gluten intolerance with no histological lesions is seen in almost 75% of patients, and therefore plays a relevant role in its development.

Dr Rodney Ford
Visit the eClinic for a second opinion
Author of: The Gluten Syndrome

1 comment:

  1. One of the causes of fatigue is thought to be iron deficiency, often referred to as anemia or borderline anemia. If treatment of your iron deficiency doesn't appear to improve your feelings of fatigue, lack of vitality and trouble concentrating, you can combat fatigue symptoms and others with a number of simple treatments.

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