Hematological findings among Jordanian children with celiac disease at presentation: a retrospective analytical study

ABSTRACT

To describe the hematological findings among children with celiac disease on presentation. This is a retrospective review which was conducted in the Pediatric Gastroenterology Department at Queen Rania Al Abdullah Hospital for Children. The records of children with celiac disease were reviewed between January 2006 and December 2012. The age of children included in the study was less or equal to 14 years on diagnosis. Complete blood count, serum ferritin, folate, vitamin B12, prothrombin time, partial prothrombin time, international normalized ratio, and tissue glutaminase antibody [IgA and IgG] were performed for all patients prior to the diagnosis. Upper gastrointestinal endoscopy was performed for all children included in the study and multiple duodenal biopsies samples were obtained during the procedure for routine histological analysis. A total of 111 children were included in the study; 53 [47.7%] were males and 58 [52.3%] were females. The mean age at diagnosis was 9 years. All children had positive tissue glutaminase antibody IgA, IgG, or both. Eleven children had leukopenia, 13 had lymphopenia, two had neutropenia, while eight had eosinophilia. Thirty four [30.4%] children had anemia. Twenty eight [25.2%] children had serum ferritin less than 7ng/ml, 30 [27%] had serum folate less than 5ng/ml and 9 [8.1%] children had vitamin B12 less than 200 pg/ml. Seventeen [60.7%] children who had serum ferritin less than 7ng/ml had also low serum folate [p=0.001]. Four [36.4%] out of eleven children with leukopenia had serum folate below 5ng/dl [p=0.2]. Vitamin B12 level in children with absolute lymphocyte count less than 1500/microL was significantly less than that of children with equal or more than 1500/microL [P value 0.02]. Twelve [10.8%] children had thrombocytosis. The mean hemoglobin level and serum ferritin were significantly lower in children with thrombocytosis than those with normal platelets [p<0.01]Celiac disease is associated with a diversity of hematological findings that include leukopenia, lymphopenia, neutropenia, and eosinophilia, as well as anemia, thrombocytopenia and thrombocytosis