Year: 2026 | Month: August | Volume: 16 | Issue: 8 | Pages: 1-11
DOI: https://doi.org/10.52403/ijhsr.20260801
Prevalence of Celiac Disease in the Pediatric Population with Anemia: A Prospective Observational Study from North India
Thumma Mary Josna Sindhuri1, Ranjeeta Dadoria1, Abhishek Yadav2, Ajay Punj1, Aishwarya Gupta1
1Junior Resident, 2,3Associate Professor, 4Professor, 5Senior Resident,
1Department of Pediatrics, 2Department of Gastroenterology, NSCB Subharti Medical College & Associated Chhatrapati Shivaji Subharti Hospital, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India.
Corresponding Author: Dr. Thumma Mary Josna Sindhuri
ABSTRACT
Background & Objectives: Celiac disease is an immune-mediated enteropathy in which iron deficiency anemia may be the only manifestation, and the diagnosis is frequently delayed. This study was undertaken to determine the prevalence of celiac disease among children with anemia and to examine the relationship between hematological parameters and celiac disease.
Materials & Methods: In a hospital-based prospective observational study conducted over twenty-one months at a tertiary care teaching hospital in North India, forty children aged four to eighteen years with anemia, defined by World Health Organization age-specific hemoglobin criteria, were enrolled. All underwent clinical evaluation, complete blood count, iron studies, and serological screening for immunoglobulin A anti-tissue transglutaminase antibodies, followed by upper gastrointestinal endoscopy with duodenal biopsy graded by the modified Marsh–Oberhuber classification. Groups were compared using the Mann–Whitney U test and the Fisher's exact test.
Results: Celiac disease was confirmed in seven of forty children, a prevalence of 17.5% (95% confidence interval 7.3-32.8). Girls comprised 62.5% of participants. Serum iron and transferrin were significantly lower in affected children (P = 0.018 and P = 0.041, respectively). By the manufacturer's cut-off, all seven biopsy-confirmed cases were antibody negative, and the only positive test occurred in a child without celiac disease. No significant association was found with sex, anemia severity, or Helicobacter pylori status.
Conclusion: The prevalence of celiac disease among children with anemia greatly exceeded that expected in the general population. In this small, single-center cohort, serology was negative in every biopsy-confirmed case; within these limits, the findings suggest that a negative serological test alone may not be sufficient to exclude celiac disease in anemic children when clinical suspicion is high, and that duodenal biopsy retains an important diagnostic role.
Key words: Anemia, Celiac disease, Children, Duodenal biopsy, Iron deficiency, Tissue transglutaminase antibody.