IRON-DEFICIENCY ANEMIA AS THE SOLE MANIFESTATION OF CELIAC-DISEASE

We report on a 40-year-old woman with a 2-year history of iron-deficie ncy anemia of unknown origin. Repeated endoscopic investigations in th e past had revealed no abnormality of the gastrointestinal system on m acroscopic examination. Oral iron supplementation was shown to have no effect on serum iron levels and had no influence on the anemia. Upper gastrointestinal endoscopy performed at our hospital confirmed normal macroscopic findings. However, jejunal biopsies revealed subtotal vil lous atrophy of the mucosa of the small intestine. A strict gluten-fre e diet led to an increase in serum iron, resolution of the anemia, and restitution of normal mucosal architecture. Thus iron-deficiency anem ia may be the lone manifestation of celiac disease.