Iron deficiency in children with coeliac disease on treatment with gluten-free diet. Role of intestinal blood loss

24 children in whom coeliac disease had been diagnosed between one and 10 years earlier were re-examined for intestinal loss of iron and activity of the disease. Mild iron deficiency by laboratory criteria and by response to iron medication was common. The children with biopsy evidence of flat mucosa or intraepithelial lymphocytosis had a greater iron loss in their stools than those patients with normal, or almost normal, histology. The data suggest that loss of iron was mainly due to intestinal blood loss rather than to shedding of mucosal cells. We conclude that treatment with iron is indicated in many children with coeliac disease as the increased losses of iron persist for long periods although absorption of iron seems to improve or be negligibly affected.