Prevalence of Celiac Disease in Patients with Nutritional Anemia in Western Part of India.

Abstract

Background: Around 1.6 billion people worldwide are affected by nutritional anemia. A small percentage of nutritional anemia cases are attributed to celiac disease (CeD). However, data on the prevalence of CeD among individuals with nutritional anemia in the Western part of India is scarce. Patients and methods: Individuals with nutritional anemia were prospectively investigated for the presence of CeD through the detection of immunoglobulin A (IgA) antitissue transglutaminase antibodies (anti-tTG Ab). Those who had a positive antibody result proceeded to have an upper gastrointestinal endoscopy, accompanied by a duodenal biopsy. The diagnosis of CeD was confirmed following Indian guidelines. Results: A total of 116 patients, including 96 females, were screened, with a mean age of 37 ± 17.8 years. Among them, 19 patients (16.3%) were positive for IgA anti-tTG antibodies. Fifteen of these antibody-positive patients agreed to undergo a duodenal biopsy, which showed villous abnormalities of modified Marsh grade 2 or higher in 11 cases. The overall seroprevalence of CeD was 16.3%, while the biopsy-confirmed prevalence stood at 9.3%. Moreover, an additional four patients (3.4%) were identified as having potential CeD. Chronic diarrhea and short stature emerged as significant predictors of CeD among patients with nutritional anemia. Conclusion: Even in the Western part of India, approximately one in 10 patients with nutritional anemia have CeD, reflecting similar findings across the country. Consequently, we should screen all patients with nutritional anemia for CeD through antitissue transglutaminase antibody testing. This is especially crucial for those with unexplained, persistent nutritional anemia that does not respond to oral iron therapy.