Iron deficiency anemia despite effective gluten-free diet in celiac disease: Diagnostic role of small bowel capsule endoscopy

2017 ◽  
Vol 49 (4) ◽  
pp. 412-416 ◽  
Author(s):  
Konstantinos Efthymakis ◽  
Angelo Milano ◽  
Francesco Laterza ◽  
Mariaelena Serio ◽  
Matteo Neri
Keyword(s):  
Celiac Disease ◽  
Small Bowel ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Capsule Endoscopy ◽  
Gluten Free Diet ◽  
Deficiency Anemia ◽  
Gluten Free ◽  
Diagnostic Role

scholarly journals Su1452 Iron Deficiency Anemia Despite Effective Gluten-Free Diet in Celiac Disease: Diagnostic Role of Video-Capsule Endoscopy

2014 ◽  
Vol 146 (5) ◽  
pp. S-472
Author(s):  
Konstantinos Efthymakis ◽  
Angelo Milano ◽  
Francesco Laterza ◽  
Mariaelena Serio ◽  
Matteo Neri
Keyword(s):  
Celiac Disease ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Capsule Endoscopy ◽  
Gluten Free Diet ◽  
Video Capsule Endoscopy ◽  
Deficiency Anemia ◽  
Gluten Free ◽  
Diagnostic Role

scholarly journals Persistent Iron Deficiency Anemia in Patients with Celiac Disease Despite a Gluten-Free Diet

Nutrients ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2176
Author(s):  
Gianpiero Stefanelli ◽  
Angelo Viscido ◽  
Salvatore Longo ◽  
Marco Magistroni ◽  
Giovanni Latella
Keyword(s):  
Celiac Disease ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Villous Atrophy ◽  
Gluten Free Diet ◽  
Deficiency Anemia ◽  
Gluten Free ◽  
Anemia Of Chronic Disease ◽  
Therapeutic Implications ◽  
Molecular Alterations

Celiac disease (CD) is an autoimmune disorder characterized by intolerance to dietary gluten in genetically predisposed subjects. Iron deficiency anemia (IDA) is a common sign in CD, being the only abnormality in approximately 40% of celiac patients. A multifactorial etiology leads to IDA in CD. The two main causes are the villous atrophy of the mucosa at the site of iron absorption (the duodenum) and the resulting inflammation, which triggers the mechanism that leads to the anemia of chronic disease. Until now, it has been unclear why some patients with CD continue to have IDA despite a careful gluten-free diet (GFD) and the normalization of villous atrophy. Furthermore, some celiac patients are refractory to oral iron supplementation despite the healing of the mucosa, and they thus require periodic intravenous iron administration. The Marsh classification evaluates the degree of inflammation and villous atrophy, but it does not assess the possible persistence of ultrastructural and molecular alterations in enterocytes. The latter was found in CD in remission after adopting a GFD and could be responsible for the persistently reduced absorption of iron and IDA. Even in non-celiac gluten sensitivity, anemia is present in 18.5–22% of patients and appears to be related to ultrastructural and molecular alterations in intestinal microvilli. It is possible that a genetic component may also play a role in IDA. In this review, we evaluate and discuss the main mechanisms of IDA in CD and the possible causes of its persistence after adopting a GFD, as well as their therapeutic implications.

Diagnostic yield of magnetically assisted capsule endoscopy versus gastroscopy in recurrent and refractory iron deficiency anemia

Endoscopy ◽  
2018 ◽  
Vol 51 (05) ◽  
pp. 409-418 ◽  
Author(s):  
Hey-Long Ching ◽  
Melissa F. Hale ◽  
Matthew Kurien ◽  
Jennifer A. Campbell ◽  
Stefania Chetcuti Zammit ◽  
...  
Keyword(s):  
Small Bowel ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Capsule Endoscopy ◽  
Diagnostic Yield ◽  
Deficiency Anemia ◽  
Gi Tract ◽  
Upper Gi ◽  
Upper Gi Tract ◽  
Magnetically Assisted

Abstract Background Small-bowel capsule endoscopy is advocated and repeat upper gastrointestinal (GI) endoscopy should be considered for evaluation of recurrent or refractory iron deficiency anemia (IDA). A new device that allows magnetic steering of the capsule around the stomach (magnetically assisted capsule endoscopy [MACE]), followed by passive small-bowel examination might satisfy both requirements in a single procedure. Methods In this prospective cohort study, MACE and esophagogastroduodenoscopy (EGD) were performed in patients with recurrent or refractory IDA. Comparisons of total (upper GI and small bowel) and upper GI diagnostic yields, gastric mucosal visibility, and patient comfort scores were the primary end points. Results 49 patients were recruited (median age 64 years; 39 % male). Combined upper and small-bowel examination using the new capsule yielded more pathology than EGD alone (113 vs. 52; P < 0.001). In upper GI examination (proximal to the second part of the duodenum, D2), MACE identified more total lesions than EGD (88 vs. 52; P < 0.001). There was also a difference if only IDA-associated lesions (esophagitis, altered/fresh blood, angioectasia, ulcers, and villous atrophy) were included (20 vs. 10; P = 0.04). Pathology distal to D2 was identified in 17 patients (34.7 %). Median scores (0 – 10 for none – extreme) for pain (0 vs. 2), discomfort (0 vs. 3), and distress (0 vs. 4) were lower for MACE than for EGD (P < 0.001). Conclusion Combined examination of the upper GI tract and small bowel using the MACE capsule detected more pathology than EGD alone in patients with recurrent or refractory IDA. MACE also had a higher diagnostic yield than EGD in the upper GI tract and was better tolerated by patients.

scholarly journals Single Cavernous Hemangioma of the Small Bowel Diagnosed by Using Capsule Endoscopy in a Child with Chronic Iron-Deficiency Anemia

2015 ◽  
Vol 48 (4) ◽  
pp. 340 ◽  
Author(s):  
Soo Jin Bae ◽  
Geol Hwang ◽  
Hyun Sik Kang ◽  
Hyun Joo Song ◽  
Weon Young Chang ◽  
...  
Keyword(s):  
Small Bowel ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Capsule Endoscopy ◽  
Cavernous Hemangioma ◽  
Deficiency Anemia
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