A short review of malabsorption and anemia

Table 1 Prevalence of CD in patients presenting with IDA

Study, yr	n	Positive serology (%)	Positive biopsy (%)	Comments
Corazza et al[16], 1995	200	8	5	IDA. 8.5% if only obscure IDA considered. All patients with positive serology were biopsied
Carroccio et al[17], 1998	85	5.8	5.8	IDA. 20% if only refractory obscure IDA considered. All patients with positive serology were biopsied. 80% of CD cases were women
Unsworth et al[18], 2000	483	6.6	4.6	Blood donors with anemia, most with IDA. Not all seropositive patients were biopsied. 95% of CD cases were women
Haslam et al[19], 2001	216	2.3	n/a	Pregnant women with anemia. Four of five anemic women with positive serology have IDA. Only serology was performed
Annibale et al[20], 2001	190	n/a	13.7	Obscure IDA. All patients were biopsied. 85% of CD cases were women
Howard et al[21], 2002	258	10.9	4.7	Majority of patients with previously not studied IDA (4% folate deficiency). Not all seropositive patients were biopsied. 83% of CD cases were women
Ransford et al[22], 2002	484	3.5	2.3	Previously not studied IDA. Not all seropositive patients were biopsied. 73% of CD cases were women
Grisolano et al[23], 2004	103	n/a	8.7	Previously not studied IDA. All patients were biopsied. 100% of CD cases were women
Mandal et al[24], 2004	504	n/a	1.8	IDA with normal upper gastroscopy. Not all patients were biopsied
Hershko et al[25], 2005	150	5.3	5.3	Previously not studied IDA. All seropositive patients were biopsied
Kalayci et al[26], 2005	135	4.4	4.4	Previously not studied children with IDA. All seropositive patients were biopsied
Zamani et al[27], 2008	206	15	14.6	Obscure IDA. All patients were biopsied
Carter et al[28], 2008	116	n/a	6.5	Previously not studied premenopausal women with IDA. All patients were biopsied

n/a: Not available data; IDA: Iron deficiency anemia; CD: Celiac disease.

Table 2 Stages of cobalamin metabolism and corresponding causes of cobalamin deficiency

Stage of cobalamin metabolism	Causes of cobalamin deficiency
Intake solely through food	Strict vegetarianism without vitamin supplementation
Digestion brings into play haptocorrin, gastric secretions (hydrochloric acid and pepsin), pancreatic and biliary secretions, enterohepatic cycle	Gastrectomy; pernicious anemia (Biermer’s disease); food-cobalamin malabsorption
Absorption brings into play intrinsic factor and cubilin	Ileal resection; malabsorption; pernicious anemia; Imerslund syndrome
Transport by transcobalamins	Congenital deficiency of transcobalamin II
Intracellular metabolism based on various intracellular enzymes	Congenital deficiency of various intracellular enzymes