Anemia of chronic disease and defective erythropoietin production in patients with celiac disease
Anemia of chronic disease and defective erythropoietin production in patients with celiac disease
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DOI：
10.3324/haematol.13255
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发表时间：
2008-12-01
期刊：
影响因子：
--
通讯作者：
Corazza, Gino Roberto
中科院分区：
文献类型：
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作者：
Bergamaschi, Gaetano;Markopoulos, Konstantinos;Corazza, Gino Roberto
背景：由于血液缺乏引起的贫血在未经治疗的乳糜泻患者中很常见。虽然乳糜泻是一种慢性疾病，其特征在于一个强烈的炎症反应的肠粘膜，很少有数据是关于贫血的慢性疾病的患病率在celiac diseases.Design和MethodsOne百和52例乳糜泻在介绍进行了研究。通过测定全血细胞计数、体内铁状态、可溶性转铁蛋白受体、促红细胞生成素、铁调素原和干扰素-γ的血清水平来研究贫血。对与遗传性血色病相关的HFE突变进行基因分型。五十三贫血患者进行了重新评估血液学反应后1年的无麸质diet.ResultsAt诊断时，腹腔疾病的贫血的患病率为34%。65名贫血患者中有53名患有铁和/或维生素缺乏症（叶酸，维生素1312）。遗传性血色素沉着症突变不影响贫血的患病率。在11例病例中，铁状态参数指示慢性疾病贫血，有时与缺铁有关（6例患者）。慢性疾病贫血患者的促红细胞生成素水平较低，贫血程度和血清干扰素-γ升高。在大多数情况下，改善无麸质饮食后，贫血的慢性疾病和贫血由于hematinic deficiencies.ConclusionsOur研究表明，除了铁和维生素缺乏症，慢性疾病贫血有一个显着的作用，在一些患者乳糜泻。无麸质饮食抑制肠道炎症变化，通过纠正铁和维生素吸收不良以及导致慢性疾病贫血的机制来改善贫血。
BackgroundAnemia due to hematinic deficiencies is common in patients with untreated celiac disease. Although celiac disease is a chronic condition characterized by an intense inflammatory response of the intestinal mucosa, scant data are available about the prevalence of anemia of chronic disease in celiac disease.Design and MethodsOne hundred and fifty-two patients with celiac disease at presentation were studied. Anemia was investigated by determining complete blood counts, body iron status, serum levels of the soluble transferrin receptor, erythropoietin, prohepcidin and interferon-gamma. Genotyping for HFE mutations associated with hereditary hemochromatosis was performed. Fifty-three anemic patients were re-evaluated for hematologic response after 1 year on a gluten-free diet.ResultsAt the time of diagnosis of celiac disease the prevalence of anemia was 34%. Fifty-three out of 65 anemic patients had either iron and/or vitamin deficiency (folate, vitamin 1312). Hereditary hemochromatosis mutations did not affect the prevalence of anemia. In 11 cases iron status parameters were indicative of anemia of chronic disease, sometimes in association with iron deficiency (6 patients). Patients with anemia of chronic disease had low levels of erythropoietin for the degree of anemia and increased serum interferon-gamma. In most cases anemia improved following a gluten-free diet, response rates being similar in anemia of chronic disease and in anemia due to hematinic deficiencies.ConclusionsOur study shows that, in addition to iron and vitamin deficiencies, anemia of chronic disease has a significant role in some patients with celiac disease. Suppression of intestinal inflammatory changes as a result of a gluten-free diet improves anemia by correcting iron and vitamin malabsorption as well as mechanisms contributing to anemia of chronic disease.