Combined Iron Deficiency Anemia and Occult Seronegative Gluten Intolerance
A 66-year old man with new symptomatic iron deficiency anemia was investigated with gastroscopy, which revealed adenomatous large inflammatory erosive polyp, which was removed. Iron reach diet and iron replacement therapy was only partially helpful but serum iron indicators were still reduced. Abnormal iron absorption was proposed. Celiac transaminase tTG- IGA and anti-gliadin and anti-endomysial antibodies were negative. Due to suspicion of seronegative gluten intolerance gluten free diet was initiated. Hemoglobin and serum iron characteristics became normal two months later. We conclude: occult iron deficiency reasons should not be missed including seronegative gluten intolerance.
Conclusion
Occult iron deficiency etiology should not be missed including seronegative gluten intolerance.
| Ferritin ng/ml | 42 | 6.6 | 10.3 | 16.1 | 10.5-307.3 | ||||
|---|---|---|---|---|---|---|---|---|---|
| Transferrin saturation (%) | 23 | 5 | 10 | 12 | 10-30 | ||||
| Iron supplement | No | Yes | Yes | No | No | No | No | No | |
| Iron reach diet | No | No | Yes | Yes | Yes | Yes | Yes | Yes | |
| Gluten free diet | No | No | No | No | No | Yes | Yes | Yes |
Table 1: Blood parameters’ dynamic during follow up and therapy for iron deficiency anemia.
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