Intended for healthcare professionals


Anaemia in blood donors is not being properly investigated

BMJ 1999; 318 doi: (Published 01 May 1999) Cite this as: BMJ 1999;318:1214
  1. R Harvey, Consultant gastroenterologist,
  2. R J Lock, Scientific officer, immunology,
  3. D J Unsworth, Consultant immunologist (joe{at}
  1. Frenchay Hospital, Bristol BS16 1LE
  2. Southmead Hospital, Bristol BS10 5ND

    EDITOR—We agree with Hin et al that occult coeliac disease is common in cases of unexplained anaemia and that testing for coeliac disease by looking for IgA endomysial antibodies is underused.1 We have been studying blood donor volunteers turned away by the National Blood Authority because they are unexpectedly found to be anaemic in routine screening before donation. The authority contacts the general practitioners of all women with a haemoglobin concentration less than 11.5 g/l and all men with a value below 12.5 g/l. In our initial pilot study, 7% (32) of 483 anaemic blood donors tested positive for IgA endomysial antibody and were therefore likely to have coeliac disease.

    After 3-6 months, we sent out questionnaires to all subjects who had been endomysial antibody positive. None of the 22 who responded had been considered for coeliac disease serology. Indeed, in 14 no follow up tests of any sort had been organised, and in 18 oral iron had been prescribed empirically with no attempt to explain the anaemia. Hin et al found that 3% of a preselected, mostly symptomatic study group had coeliac disease. Our subjects all felt well enough to donate blood and had no specific health complaints. Targeted serological testing, particularly focusing on cases of unexplained anaemia, offers a simple and worthwhile way to diagnose unsuspected coeliac disease in a large number of cases.


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