Occult celiac disease in adult Omanis with unexplained iron deficiency anemia
Fraser, J.S.; Woodhouse, N.J.; El-Shafie, O.T.; Al-Kindy, S.S.; Ciclitira, P.J.
Saudi Medical Journal 24(7): 791
2003
ISSN/ISBN: 0379-5284 PMID: 12883621 Document Number: 559013
Serum samples were obtained from 51 patients (43 females; 17-61 years old, mean age=23 years) with unexplained iron deficiency anaemia attending clinics in Sultan Qaboos University Hospital, Muscat, Oman. The samples were analysed for IgA and IgG anti-tissue transglutaminase (tTG) antibodies. Those positive for IgA tTG underwent testing for IgA antiendomysial antibodies (EMA). In the case of positive IgG tTG in the absence of IgA tTG, selective IgA deficiency was excluded by measuring total IgA and IgG1 EMA. All patients with positive serology were offered endoscopy and small bowel biopsy to confirm the diagnosis of coeliac disease. Two patients were found to have positive IgA tTH and IgA EMA. Two patients had positive IgG tTH but neither were IgA deficient, nor did they have IgG1 EMA. One of the patients had been biopsied which showed subtotal villous atrophy. Both patients were advised to take a gluten-free diet. This is the first reported use of EMA titres as a screening test for the presence of coeliac disease in the Arabian peninsula.