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The prevalence of gluten-sensitive enteropathy in iron-deficient anemia patients
January 05, 2009Gluten sensitive enteropathy (GSE) is an autoimmune enteropathy due to food gluten intolerance in genetically predisposed people. While GSE was thought to be a rare disease in the past and was believed to be essentially a disease of Europeans, recent screening studies showed that GSE is one of the most frequent genetically based diseases occured worldwide. Iron deficiency anemia could be a sole manifestation of GSE, and it might result in the delayed diagnosis of GSE, resulting in complications.
A research team led by Prof. Reza Malekzadeh studied the prevalence of gluten sensitive enteropathy (GSE) in a large group of patients with iron deficiency anemia (IDA) of obscure origin. Their findings will be published on December 28, 2008 in the World Journal of Gastroenterology.
In this prospective study, 4120 patients with IDA were enrolled in this study. Anti-endomysial antibody (EMA) and tissue transglutaminase antibody (tTG) levels were evaluated and duodenal biopsies were taken and scored according to the Marsh classification. The diagnosis of GSE was based on a positive serological test and abnormal duodenal histology. Gluten free diet (GFD) was advised for all the GSE patients.
Of the 4 120 IDA patients, 206 (95 male) patients were found to have IDA of obscure origin. Thirty out of 206 patients (14.6%) had GSE. Sixteen patients had Marsh 3, 12 had Marsh 2, and 2 had Marsh 1 lesions. The severity of anemia was in parallel with the severity of duodenal lesions. Twenty-two GSE patients (73.3%) had no gastrointestinal symptoms. Fourteen GSE patients who adhered to GFD without receiving iron supplementation agreed to undergo follow up visits. After 6 mo of GFD, their mean hemoglobin levels (Hb) increased from 9.9 ± 1.6 to 12.8 ± 1.0 g/dL (P < 0.01). Interestingly, in 6 out of 14 patients who had Marsh 1/2 lesions on duodenal biopsy, mean Hb increased from 11.0 ± 1.1 to 13.1 ± 1.0 g/dL (P < 0.01) while they did not receive any iron supplementation. These results indicate that there is a high prevalence of GSE in patients with IDA of obscure origin. Gluten free diet can improve anemia in GSE patients who have mild duodenal lesions without villous atrophy.
World Journal of Gastroenterology
Of the 4 120 IDA patients, 206 (95 male) patients were found to have IDA of obscure origin. Thirty out of 206 patients (14.6%) had GSE. Sixteen patients had Marsh 3, 12 had Marsh 2, and 2 had Marsh 1 lesions. The severity of anemia was in parallel with the severity of duodenal lesions. Twenty-two GSE patients (73.3%) had no gastrointestinal symptoms. Fourteen GSE patients who adhered to GFD without receiving iron supplementation agreed to undergo follow up visits. After 6 mo of GFD, their mean hemoglobin levels (Hb) increased from 9.9 ± 1.6 to 12.8 ± 1.0 g/dL (P < 0.01). Interestingly, in 6 out of 14 patients who had Marsh 1/2 lesions on duodenal biopsy, mean Hb increased from 11.0 ± 1.1 to 13.1 ± 1.0 g/dL (P < 0.01) while they did not receive any iron supplementation. These results indicate that there is a high prevalence of GSE in patients with IDA of obscure origin. Gluten free diet can improve anemia in GSE patients who have mild duodenal lesions without villous atrophy.
World Journal of Gastroenterology
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tTGA: Is it more essential in diagnosis of gluten sensitive enteropathy?
CD is a highly prevalent disease (1:100 to 1:300) which fulfils most of the criteria favoring mass screening. Despite this, screening for gluten sensitive enteropathy (GSE) is still controversial due to its dubious benefits and the acceptance of a gluten-free diet (GFD).
A rare case of collagenous colitis presenting as protein-losing enteropathy
Since the first report in 1976, collagenous colitis has been associated with a variety of conditions, including use of non-steroidal anti-inflammatory drugs and proton pump inhibitors.
Researchers identify gene responsible for rare childhood disease
The chromosomal abnormality that causes a rare, but often fatal, disorder that affects infants has been identified by researchers at the University of California, San Diego School of Medicine, who happened to treat two young children with the disease in San Diego - two of perhaps a dozen children in the entire country diagnosed with the disorder.
Potentially Safe and Effective Therapy Revealed for Patients with Protein-Losing Enteropathy
Researchers at the Burnham Institute for Medical Research (Burnham Institute) have developed the first model to study intestinal protein leakage in mice, allowing the team to control and replicate both genetic deficiencies and environmental damages in an in vivo setting.
Cocktails ameliorate celiac disease
The University Rovira i Virgili (Spain), the company Trace Biotech AG (Braunschweig), the Institut für Mikrotechnik Mainz GmbH (IMM, Mainz), and seven other European partners are jointly developing a biosensor for the detection of gluten in food. The goal of the ambitious project is to manufacture a disposable microsystem with integrated modules for a standardised extraction and analysis of gluten in food samples. The system, for the first time, will permit patients suffering from celiac disease (gluten sensitive enteropathy) to conduct an on-the-spot analysis of fresh, cooked, or industrially processed food with the aid of a screening procedure. The project is funded with more than 3 M
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