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Celiac Disease in an Urban VA Population with Iron Deficiency: The Case Against Routine Duodenal Biopsy

Digestive diseases and sciences, 2011-07, Vol.56 (7), p.2037-2041 [Peer Reviewed Journal]

Springer Science+Business Media, LLC (Outside the USA) 2011 ;2015 INIST-CNRS ;COPYRIGHT 2011 Springer ;Springer Science+Business Media, LLC 2011 ;ISSN: 0163-2116 ;EISSN: 1573-2568 ;DOI: 10.1007/s10620-010-1549-y ;PMID: 21222157 ;CODEN: DDSCDJ

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Title:
Celiac Disease in an Urban VA Population with Iron Deficiency: The Case Against Routine Duodenal Biopsy
Author: Abbass, Rami ; Hopkins, Marc ; Dufour, D. Robert ; Schallheim, Jason ; Szeto, Oliver J. ; Korman, Louis Y. ; Amdur, Richard L. ; Lipman, Timothy O.
Subjects: Adult ; African Americans - statistics & numerical data ; Aged ; Aged, 80 and over ; Analysis ; Anemia, Iron-Deficiency - diagnosis ; Anemias. Hemoglobinopathies ; Biochemistry ; Biological and medical sciences ; Biopsy ; Celiac disease ; Celiac Disease - epidemiology ; Celiac Disease - pathology ; Diseases of red blood cells ; Duodenum - pathology ; Endoscopy, Digestive System ; Feeding. Feeding behavior ; Female ; Fundamental and applied biological sciences. Psychology ; Gastroenterology ; Gastroenterology. Liver. Pancreas. Abdomen ; Hematologic and hematopoietic diseases ; Hepatology ; Hospitals, Veterans ; Hospitals, Veterans - statistics & numerical data ; Humans ; Iron - deficiency ; Male ; Medical centers ; Medical research ; Medical sciences ; Medicine ; Medicine & Public Health ; Medicine, Experimental ; Middle Aged ; Oncology ; Original Article ; Other diseases. Semiology ; Prevalence ; Retrospective Studies ; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus ; Transglutaminases - analysis ; Transglutaminases - blood ; Transplant Surgery ; Urban Health ; Vertebrates: anatomy and physiology, studies on body, several organs or systems ; Veterans Health - statistics & numerical data
Is Part Of: Digestive diseases and sciences, 2011-07, Vol.56 (7), p.2037-2041
Description: : Background Celiac disease is considered an under-recognized cause of iron deficiency. Small intestinal biopsy is proposed to be part of routine evaluation for iron deficiency. Aims To determine the prevalence of celiac disease in an urban, mostly male, mostly minority population with iron deficiency. Methods Clinical, endoscopic, and pathologic records of veterans who had undergone esophagogastroduodenoscopy (EGD) and duodenal biopsy for iron deficiency at an urban, tertiary care Veterans Affairs Medical Center were reviewed. The yield of positive duodenal biopsies for celiac disease and pre-defined clinically important findings on EGD were calculated. Confounding factors were assessed in multivariate analysis. The main outcome measures were prevalence of celiac disease and prevalence of clinically important findings on upper gastrointestinal endoscopy. Results The records of 310 veterans were reviewed. Mean age was 63, range 32–91 years old. Most were male (89%) and African–American (73%). Five of 306 small intestinal biopsies were consistent with celiac disease (type 1 lesions), but tissue transglutaminase obtained in four of the patients was normal, making the prevalence of potential celiac disease 0.33% (95% CI: 0.06–1.83%). Fifty of 310 EGDs demonstrated findings that were considered to have a moderate or high probability of producing iron deficiency (16.1, 95% CI: 12.5–20.6%). Conclusions The prevalence of celiac disease is low in an urban, predominately male, African–American population with iron deficiency. Routine small intestinal biopsy for celiac disease in similar populations should not be done. EGD remains clinically important.
Publisher: Boston: Springer US
Language: English
Identifier: ISSN: 0163-2116
EISSN: 1573-2568
DOI: 10.1007/s10620-010-1549-y
PMID: 21222157
CODEN: DDSCDJ
Source: MEDLINE
Alma/SFX Local Collection
ProQuest Central

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Celiac Disease in an Urban VA Population with Iron Deficiency: The Case Against Routine Duodenal Biopsy

Springer Science+Business Media, LLC (Outside the USA) 2011 ;2015 INIST-CNRS ;COPYRIGHT 2011 Springer ;Springer Science+Business Media, LLC 2011 ;ISSN: 0163-2116 ;EISSN: 1573-2568 ;DOI: 10.1007/s10620-010-1549-y ;PMID: 21222157 ;CODEN: DDSCDJ

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