Unawareness of gastrointestinal symptomatology in adult coeliac patients with unexplained iron‐deficiency anaemia presentation

Summary Background Most adults with coeliac disease have a subclinical form of the disease and iron‐deficiency anaemia may be the sole presenting symptom. Aim To evaluate demographic, clinical and biochemical characteristics of adult coeliac disease patients presenting with iron‐deficiency anaemia. Patients A total of 108 iron‐deficiency anaemia patients in whom coeliac disease has been diagnosed were studied. As a control group 108 non‐coeliac iron‐deficiency anaemia patients, comparable for sex and age, were studied. Results Of the 108 coeliac disease patients, 95 (88%) were female (mean age 34 years, range 19–72) and 13 (12%) were male (mean age 33 years, range 15–65). The median duration of iron‐deficiency anaemia before diagnosis was 66 months in coeliac disease patients and 14 months in the iron‐deficiency anaemia control group (P = 0.0001). The occurrence of at least one gastrointestinal symptom, not spontaneously reported, was observed in 92 (85%) patients with coeliac disease and in 67 (62%) patients in the control group (P = 0.001). The concomitant presence of diarrhoea, abdominal pain and abdominal bloating was detected in 14% patients with coeliac disease with respect to 3% in the control group (P = 0.005). Conclusions The vast majority of coeliac disease patients with iron‐deficiency anaemia presentation were unaware of the gastrointestinal symptoms and this relationship is useful for diet compliance.