Background: Celiac disease (CD) is an immune-mediated intestinal disease caused by a hypersensitivity to gluten in genetically susceptible people. The most frequent type of anemia in the world is iron-deficiency anemia (IDA), which is also thought to be the most typical extra intestinal symptom of celiac disease.
Aim: This study aimed to determine the prevalence of CD in patients with unexplained refractory IDA by using anti-tissue transglutaminase (anti-tTG) antibodies or by endoscopic biopsy in North-Western Saudi Arabia (Hail Province)
Design and Methods: This is a cross-sectional discipline that was done at the King Salman Specialist Hospital, Hail, Saudi Arabia during the period from January 2019 to December 2021. We evaluated two thousand four hundred adult Saudi patients with IDA for etiology. Of those, 270 patients (11.25%) were found to have refractory IDA. IgA and IgG tissue transglutaminase (tTG) antibodies were tested in sera from patients with IDA of unknown cause using an ELISA test. Intestinal endoscopic biopsies were taken from the second part of the duodenum in these patients. Histopathologic examination results of patients categorized based on Marsh classification.
Results: In 16 patients (5.9%) with refractory IDA, anti-tTG antibodies were found to be positive; histopathologic evidence of CD was seen in 15 patients (5.5%). The mean age of the diagnosed patients was 28.6 ± 8.1 years and all of them were females.
Conclusions: Celiac disease was more common in patients with refractory iron deficient anemia. In individuals with refractory iron deficiency anemia, we advise serological testing for early detection of celiac disease.