SNFGE SNFGE
 
Thématique :
- Colo-proctologie
Originalité :
Intermédiaire
Solidité :
Très solide
Doit faire évoluer notre pratique :
Immédiatement
 
 
Nom du veilleur :
Docteur Pauline JOUET
Coup de coeur :
 
 
Gastroenterology
  2018/08  
 
  2018 Aug;155(2):374-382.e1.  
  doi: 10.1053/j.gastro.2018.04.016.  
 
  Prevalence of Celiac Disease in Patients With Iron Deficiency Anemia - A Systematic Review With Meta-analysis.  
 
  Mahadev S, Laszkowska M, Sundström J, Björkholm M, Lebwohl B, Green PHR, Ludvigsson JF  
  https://www.ncbi.nlm.nih.gov/pubmed/29689265  
 
 

Abstract

BACKGROUND & AIMS:

Anemia is common in patients with celiac disease (CD) and a frequent mode of presentation. Guidelines recommend screening patients with iron-deficiency anemia (IDA) for CD. However, the reported prevalence of CD in patients with IDA varies. We performed a systematic review to determine the prevalence of biopsy-verified CD in patients with IDA.

METHODS:

We performed a systematic review of articles published in PubMed Medline or EMBASE through July 2017 for the term "celiac disease" combined with "anemia" or "iron deficiency." We used fixed-effects inverse variance-weighted models to measure the pooled prevalence of CD. Meta-regression was used to assess subgroup heterogeneity.

RESULTS:

We identified 18 studies composed of 2998 patients with IDA for inclusion in our analysis. Studies originated from the United Kingdom, United States, Italy, Turkey, Iran, and Israel. The crude unweighted prevalence of CD was 4.8% (n = 143). Using a weighted pooled analysis, we found a prevalence of biopsy-confirmed CD of 3.2% (95% confidence interval = 2.6-3.9) in patients with IDA. However, heterogeneity was high (I2 = 67.7%). The prevalence of CD was not significantly higher in studies with a mean participant age older or younger than 18 years or in studies with a mixed-sex vs female-predominant (≥60%) population. On meta-regression, year of publication, female proportion, age at CD testing, and prevalence in the general population were not associated with the prevalence of CD in patients with IDA. In the 8 studies fulfilling all our quality criteria, the pooled prevalence of CD was 5.5% (95% confidence interval = 4.1-6.9).

CONCLUSIONS:

In a systematic review and meta-analysis, we found that approximately 1 in 31 patients with IDA have histologic evidence of CD. This prevalence value justifies the practice of testing patients with IDA for CD.

 

 
Question posée
 
Quelle est la prévalence de la maladie coeliaque en cas d’anémie par carence en fer ?
 
Question posée
 
Dans cette revue systématique portant sur 18 études (2998 patients), environ un patient sur 31 avait des signes histologiques de maladie coeliaque, avec une prévalence qui n’était pas influencée par le sexe, l’âge ou la prévalence de la maladie dans la population étudiée.
 
Commentaires

Une étude qui confirme les recommandations actuelles de faire des biopsies duodénales systématiquement en cas d’anémie ferriprive.

 
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