cqvip:Background: Iron deficiency anemia (IDA) may be the sole manifestation of celi ac disease. The role of routine small bowel biopsies obtained during endoscopy i n the evaluation of IDA is unclear. This study assessed the usefulness of routin e small bowel biopsies in patients presenting with IDA. Study: Evaluation of 103 consecutive patients with IDA undergoing panendoscopy with routine small bowel biopsies was performed. All patients had a diagnosis of IDA with either a ferrit in less than 15 μg/L or iron saturation less than 8%. Celiac disease was defin ed as total or partial villous atrophy with intraepithelial lymphocytosis, histo logically, and a clinical response to gluten free diet. Gastrointestinal symptom s were recorded. Results: Nine patients (8.7%) were diagnosed with celiac disea se. Of these patients, endoscopic lesions potentially responsible for IDA were f ound in 33%. We found no statistically significant difference when comparing re ports of diarrhea, weight loss, abdominal pain, nausea or vomiting, aspirin or N SAID use, or menopausal status with celiac disease status. Conclusions: Routine small bowel biopsies to evaluate for celiac disease are indicated in the evaluat ion of patients with IDA. The finding of endoscopic lesions that may otherwise e xplain IDA should not preclude small bowel biopsy.
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