Intérêt des biopsies duodénales dans l’exploration de l’anémie ferriprive chez le sujet âgé

Abstract

Routine duodenal biopsy in adult patients with iron deficiency anaemia (IDA) is a recognised recommendation for adults. Chronic IDA is an uncommon presentation of celiac disease in elderly patients. To determine the usefulness of routine distal duodenal biopsy in diagnosing celiac disease in elderly patients with IDA whose endoscopy revealed no gastrointestinal cause of iron deficiency. Four hundred and forty-four patients with unexplained IDA aged between 16 and 85 years, who underwent routine duodenal biopsy were included in the study. These patients were divided into two groups according to their age (≤ 60 and > 60 years). Three hundred and thirty-five women and 109 men constituted the study population. The mean age was 40.5 years. Duodenal biopsy revealed typical histological features of celiac disease in 4.9%. In the group of patients below 60 years, the prevalence of celiac disease was 64%. No patients in a group above 60 years had celiac disease. Helicobacter pylori (HP) gastritis was present in 90% of the cases. No cases of duodenal villous atrophy has been noted in patients over 60 years. HP gastritis would be the most common cause of IDA in patients with normal gastrointestinal endoscopy in our country.