Prevalence of iron deficiency anemia in chronic diarrhoea and celiac disease - a western UP experience.

Abstract

To study the prevalence of iron deficiency anaemia in chronic diarrhoea and celiac disease. Cases included 45 children between 1-12 years with chronic diarrhoea, who underwent investigations like haemogram with GBP, RBC indices, serum iron and TIBC. After a course of antibiotic therapy for 6 weeks with iron and folic acid with no improvement noted within 2 weeks, they were subjected to duodenal biopsy. If biopsy showed features of celiac disease, then anti-endomysial antibody test was performed to substantiate the diagnosis. 30 cases (66.7%) were males and 15 (33.3%) females. 8 cases (17.8%) had watery diarrhoea, 20 (44.4%) semiformed and 17 (37.8%) had watery and semiformed diarrhoea. Bloody diarrhoea was present in 5 (11.1%) and abdominal distension in 21 cases (46.7%). Pallor seen in all the cases. The mean age of the cases was 55 ± 1.5 months and mean duration of diarrhoea was 18 ± 1.4 months. Mean haemoglobin observed was 8.1 ± 1.6 gm%. MCV, MCH and MCHC were 79.1 ± 8.6 fl, 26.9 ± 3 pg and 29.6 ± 2.3 g/dl respectively. Mean serum iron was 32.1 ± 1.2 g/ dl and TIBC was 432 ± 3.2 g/ dl. On peripheral smear, 28 cases (82.4%) showed microcytic hypochromic anaemia. 26 cases showed evidence of celiac disease on duodenal biopsy. Anti endomysial antibody (AEA) test was positive in 15 of the 19 celiac cases on which performed. Mean duration of diarrhoea (23.5 months) was significantly more in celiacs as compared to non-celiacs (11.6 months). Better awareness of the clinical profile and early detection of celiac disease would help detection and management of iron deficiency anaemia associated with celiac disease.