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The impact of morphological changes in small bowel mucosa on iron metabolism in children with celiac disease

[Pediatrics]
Leonid Klimov; Marina Stoyan; Victoria Kuryaninova; Vyacheslav Kashnikov; Valentina Botasheva; Svetlana Dolbnya; Dayana Asaturova; Svetlana Kashnikova;

A comprehensive study was carried out, which implied clinical and laboratory tests involving 164 children with morphologically proven celiac disease, of which 44 (26.8 %) had iron-deficiency anemia (IDA) verified in them; 79 (48.2 %) had latent iron deficiency (LID), and another 41 (25.0 %) revealed no proven signs of iron deficiency (ID). The gastro-intestinal symptoms seen as the initial and most pathognomonic manifestation of celiac disease, are mostly typical of children with IDA. An analysis of the registered complaints and measurements shows that children with IDA have low body weight and height prevailing among them. The children with celiac disease accompanied with ID revealed higher levels of antibodies to tissue transglutaminase. Among children with IDA the severest atrophy of the small intestine mucosa (Stage 3С by Маrsh – Оberhuber) was detected in 80.0 % of cases, while among those with no ID only 21.1 % had the same issue. During that, there was also correlation found between the stage of the atrophy and the serum levels of iron (r= –0.32, p<0.005) and serum ferritin (r= –0.50, p<0.001).

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Keywords: celiac disease, children, serological markers, iron deficiency anemia, latent iron deficiency, atrophy of mucosa


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