1
|
Response to Zanella et al. Am J Gastroenterol 2015; 110:1241. [PMID: 26263363 DOI: 10.1038/ajg.2015.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
|
2
|
Elli L, Poggiali E, Tomba C, Andreozzi F, Nava I, Bardella MT, Campostrini N, Girelli D, Conte D, Cappellini MD. Does TMPRSS6 RS855791 polymorphism contribute to iron deficiency in treated celiac disease? Am J Gastroenterol 2015; 110:200-2. [PMID: 25567183 DOI: 10.1038/ajg.2014.354] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Luca Elli
- Center for the Prevention and Diagnosis of Celiac Disease, Gastroenterology and Endoscopy, Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Pathophysiology and Transplant, Università degli Studi di Milano, Milan, Italy
| | - Erika Poggiali
- 1] Internal Medicine Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy [2] Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Carolina Tomba
- Center for the Prevention and Diagnosis of Celiac Disease, Gastroenterology and Endoscopy, Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Pathophysiology and Transplant, Università degli Studi di Milano, Milan, Italy
| | - Fabio Andreozzi
- 1] Internal Medicine Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy [2] Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Isabella Nava
- Internal Medicine Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Maria Teresa Bardella
- Center for the Prevention and Diagnosis of Celiac Disease, Gastroenterology and Endoscopy, Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Pathophysiology and Transplant, Università degli Studi di Milano, Milan, Italy
| | | | | | - Dario Conte
- Center for the Prevention and Diagnosis of Celiac Disease, Gastroenterology and Endoscopy, Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Pathophysiology and Transplant, Università degli Studi di Milano, Milan, Italy
| | - Maria Domenica Cappellini
- 1] Internal Medicine Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy [2] Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| |
Collapse
|
3
|
Abstract
Endoscopic gastrointestinal workup fails to establish the cause of iron deficiency anemia (IDA) in a substantial proportion of patients. In patients referred for hematologic evaluation with unexplained or refractory IDA, screening for celiac disease, autoimmune gastritis, Helicobacter pylori, and hereditary forms of IDA is recommended. About 4% to 6% of patients with obscure refractory IDA have celiac disease, and autoimmune gastritis is encountered in 20% to 27% of patients. Stratification by age cohorts in autoimmune gastritis implies a disease presenting as IDA many years before the establishment of clinical cobalamin deficiency. Over 50% of patients with unexplained refractory IDA have active H pylori infection and, after excluding all other causes of IDA, 64% to 75% of such patients are permanently cured by H pylori eradication. In young patients with a history suggestive of hereditary iron deficiency with serum ferritin higher than expected for IDA, mutations involving iron trafficking and regulation should be considered. Recognition of the respective roles of H pylori, autoimmune gastritis, celiac disease, and genetic defects in the pathogenesis of iron deficiency should have a strong impact on the current diagnostic workup and management of unexplained, or refractory, IDA.
Collapse
|