Coeliac disease

doi:10.1136/bmj.a3058

Published 19 February 2009, doi:10.1136/bmj.a3058
Cite this as: BMJ 2009;338:a3058

Practice

Easily Missed?

Coeliac disease

Roger Jones, Wolfson professor of general practice¹, Sarah Sleet, chief executive²

¹ Department of General Practice and Primary Care, King’s College London, London SE11 6SP , ² Coeliac UK, High Wycombe HP11 2HS

Correspondence to: R Jones roger.jones@kcl.ac.uk

doi:10.1136/bmj.a3066doi:10.1136/bmj.b380doi:10.1136/bmj.b491

The first 150 words of the full text of this article appear below.

1% prevalence in general Western populations(possibly higher in Western Europe and Scandinavia)
3-6% prevalencein type 1 diabetes
5-10% prevalence in first degree relatives
10-15%prevalence in symptomatic iron deficiency anaemia
3-6% prevalencein asymptomatic iron deficiency anaemia*
1-3% prevalence inosteoporosis

*Pregnancy may unmask the effect of iron malabsorption,so testing pregnant women with moderate to severe anaemia isworth while

A 32 year old woman with fatigue and symptomsof irritable bowel syndrome has not responded to the usual treatmentfor the condition and has borderline iron deficiency anaemia.Her general practitioner requests tissue transglutaminase antibody(tTGA) testing, and the levels are found to be raised, leadingto a diagnosis of coeliac disease.

The finding of iron deficiency anaemia is not consistent withthe diagnosis of a functional bowel disorder, and other possibilitiesneeded to be considered, including inflammatory bowel disease,colorectal cancer, and coeliac disease. Although . . . [Full text of this article]

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