Efficacy of gluten-free diet alone on recovery from iron deficiency anemiain adult celiac patients

OBJECTIVE: Iron deficiency anemia has been reported as the most frequent ex traintestinal symptom in adult celiac disease. Prospective studies on the e ffect of gluten-free diet on recovery from iron deficiency anemia are lacki ng. The aim of this study was to verify in adult patients with celiac disea se the efficacy of and the time course of recovery from iron deficiency ane mia by a gluten-free diet alone. METHODS: We studied 190 consecutive adult patients with iron deficiency ane mia, screened for celiac disease by duodenal biopsies. New diagnosed celiac patients were invited to follow a gluten-free diet alone without iron supp lementation. After 6 months of diet, duodenal biopsies were performed and h ematological tests were repeated at 6, 12, and 24 months. RESULTS: Celiac disease was diagnosed in 26 (24 women, 2 men; 13.7%) adult patients. After 6 months of gluten-free diet 14 of 18 (77.8%) female patien ts recovered from anemia, but only 5 of 18 (27.8%) reversed from iron defic iency. At 12-month control all but one patient (94.4%) recovered from anemi a and 9 patients (50%) from iron deficiency. After 24 months of diet, only the patient who did not recover from anemia at 12-month control was still a nemic, whereas 10 patients (55.5%) reversed from iron deficiency. A signifi cant inverse correlation (r = -0.7141, p = 0.0003) between increase of Hb c oncentrations and decrease of individual histological scores of duodenitis was observed. CONCLUSIONS: A screening for celiac disease should be carried out in adult patients with iron deficiency anemia. Recovery from anemia occurs between 6 and 12 months on a gluten-free diet alone as a consequence of normalizatio n of histological alterations of the intestinal mucosa. (Am J Gastroenterol 2001;96:132-137. (C) 2001 by Am. Cell. of Gastroenterology).