RED BLOOD INDICES, PLATELET COUNT AND TRANSFERRIN LEVELS IN CELIAC PATIENTS WITH AND WITHOUT TYPE 1 DIABETES MELLITUS IN HYDERABAD, SINDH, PAKISTAN

Abstract

OBJECTIVE: To analyze the hematological manifestations among celiac disease  (CD) and CD with type-1 diabetes mellitus  (T1DM) children to aid in differential diagnosis and management of disease. METHODS: This study was conducted at Institute of Biotechnology and Genetic Engineering, University of Sindh, Jamshoro, Pakistan.  CD pediatric patients were diagnosed through serological or intestinal biopsy. The individuals were divided into 5 groups (35 each); Control (A), diagnosed cases of CD (B), individuals affected with celiac-like indications (C), T1DM patients with celiac-like symptoms (D) and T1DM patients (E). RESULTS:  Mean age of 175 participants was 9.5±1.2 years. Mean hemoglobin level (mg/dl) was 9.1±1.1, 9.03±1.4, 8.64±1.2 and 11.7±1.3 in group-B, group-C, group-D and group-E respectively as compared to 13.02±1.5 in Group-A (p<0.001). Mean corpuscular volume (MCV) [fl] was 64.1±5.4, 68.5±7.8, 57.6±6.0 and 69.4±4.4 in group-B, group-C, group-D and group-E respectively as compared to 84.4±7.3 in Group-A (p<0.001). Mean corpuscular hemoglobin (MCH) [group-B: 24.1pg, group-C: 25.5pg, group-D: 24.6pg] and mean corpuscular hemoglobin concentration (MCHC) [group-B: 29.3 g/dl, group-C: 277.9 g/dl, group-D: 31.5 g/dl] were decreased among all celiac affected cases. For group-E the hemoglobin, MCV and MCHC were in the normal ranges. Platelet Count (cells/ul) was 689±178x103, 702±141x103, 518±124x103 and 529±101x103 in group-B, group-C, group-D & group-E respectively as compared to 326±98x103 in group A (p<0.01). Mean Transferrin levels (mg/dl) were 411.5±24.8; 387.7±22.4; 406.4±21.4 & 368.8±22.0 in group-B, group-C, group-D and group-E and 271.1±39.1 in group-A (p<0.01). CONCLUSION: Hematological anomalies; like anemia and thrombocytosis are frequently present in mismanaged and late diagnosed CD children.