Significance of low ferritin without anaemia in screen‐detected, adult coeliac disease patients

Adult Male SYMPTOMS LEVEL 610 3121 Internal medicine DIAGNOSIS 3121 DIET 03 medical and health sciences 0302 clinical medicine follow-up Humans SERUM FERRITIN Prospective Studies ferritin MULTIFACTORIAL Anemia ASSOCIATION Original Articles General medicine, internal medicine and other clinical medicine 3. Good health IRON-DEFICIENCY Celiac Disease quality of life Ferritins Quality of Life symptoms Female coeliac disease
DOI: 10.1111/joim.13548 Publication Date: 2022-08-04T15:49:41Z
ABSTRACT
AbstractBackgroundLow ferritin without anaemia has been linked to adverse health effects.ObjectivesTo investigate the prevalence and clinical significance of low ferritin in screen‐detected coeliac disease.MethodsSeventy‐six screen‐detected coeliac disease patients were enrolled in the prospective collection of comprehensive clinical, laboratory and histological data at diagnosis and after 1–2 years on a gluten‐free diet (GFD). All variables were compared between patients with different ferritin levels.ResultsAt coeliac disease diagnosis, six patients had anaemia. Of the 70 nonanaemic patients, ferritin levels were <15 μg/L in 21%, 15–29 μg/L in 19%, 30–99 μg/L in 36% and ≥100 μg/L in 24%. Those with lower ferritin were more often females, had lower body mass index, haemoglobin and villous height–crypt depth ratio and also had higher intra‐epithelial lymphocyte CD3+ levels in duodenal biopsies. The groups did not differ in neurological or gastrointestinal symptoms, health‐related quality of life, bone mineral density, liver values, vitamin, albumin or coeliac autoantibody levels or the prevalence of comorbidities. Median ferritin levels increased from 41.5 μg/L to 86.0 μg/L on GFD (p < 0.001). Ferritin remained <30 μg/L in 21% of patients but was not associated with dietary compliance, nor was any correlation between changes in ferritin and quality of life, gastrointestinal symptoms, autoantibody levels or degree of histological damage detected.ConclusionDecreased ferritin is a frequent finding in screen‐detected coeliac disease and may not be fully restored on a GFD. However, low ferritin levels are not associated with more severe symptoms or poorer quality of life.
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