Improving detection of celiac disease patients: a prospective study in iron-deficient blood donors without anemia in north Italy

Eur J Gastroenterol Hepatol. 2014 Jul;26(7):721-4. doi: 10.1097/MEG.0000000000000100.

Abstract

Objective: To evaluate the prevalence of celiac disease in asymptomatic iron-deficient blood donors without anemia.

Material and methods: Between the period February 2004 and January 2006, iron-deficient male donors with serum ferritin less than 30 ng/ml and female donors with serum ferritin less than 10 ng/ml were screened for immunoglobulin A (IgA) and IgG antitissue transglutaminase antibodies and donors with positive antibody titers were referred for endoscopy with multiple biopsies of the second/third part of duodenum. The frequency of celiac disease in iron-deficient blood donors without anemia and the predictive value of ferritin levels were analyzed.

Results: Of the 1679 blood donors, 579 (34.4%) were identified as iron deficient and screened for celiac disease. 290 (50%) were men (mean age: 39 years; range: 19-65) and 289 (50%) were women (mean age: 37 years; range: 19-63). Thirteen donors (2.2%) were positive for serum IgA antitissue transglutaminase antibodies, of whom six were men (2.0%) and seven were women (2.4%). 10 donors of 13 (1.7%) at histology presented alterations in the mucosal architecture according to the modified Marsh classification (Marsh I-III). Low ferritin level was not predictive for celiac disease (median serum ferritin level in celiac donors 14.7 ng/ml and in nonceliac donors 15.8 ng/ml, Wilcoxon test: P not significant). The prevalence of celiac disease among iron-deficient blood donors without anemia was 1.7%.

Conclusion: The prevalence of celiac disease in our population of asymptomatic iron-deficient blood donors without anemia was 1.7%. We suggest screening for celiac disease in iron-deficient individuals without anemia to increase diagnosis of asymptomatic celiac disease.

MeSH terms

  • Adult
  • Aged
  • Anemia, Iron-Deficiency
  • Asymptomatic Diseases / epidemiology*
  • Autoantibodies / blood
  • Blood Donors / statistics & numerical data*
  • Celiac Disease / blood*
  • Celiac Disease / diagnosis*
  • Celiac Disease / epidemiology
  • Female
  • Ferritins / blood
  • GTP-Binding Proteins / immunology
  • Humans
  • Iron Deficiencies*
  • Italy / epidemiology
  • Male
  • Mass Spectrometry
  • Middle Aged
  • Prevalence
  • Prospective Studies
  • Protein Glutamine gamma Glutamyltransferase 2
  • Seroepidemiologic Studies
  • Transglutaminases / immunology
  • Young Adult

Substances

  • Autoantibodies
  • Ferritins
  • Protein Glutamine gamma Glutamyltransferase 2
  • Transglutaminases
  • GTP-Binding Proteins