Celiac disease and H. pylori existence in the adult population and its effects on anemia incidence.

OBJECTIVE: Anemia is a common extraintestinal symptom of celiac disease; however, inflammation and Helicobacter pylori (HP) infection can also induce anemia. Anemia is associated with both H. pylori infection and celiac disease, which can significantly impact public health. In our study, we aimed to determine the impact of H. pylori infection on anemia in celiac disease adults.

PATIENTS AND METHODS: In this study, 150 celiac disease patients with endoscopy results were retrospectively analyzed. Patients' gender, age, Oberhuber-Marsh scores, presence of H. pylori, presence of anemia, serum tissue transglutaminase (TTG), immunoglobulin (Ig) A and IgG levels, anti-gliadin antibody (AGA) IgA and IgG levels, Endomysial Antibody (EMA) IgA and IgG levels, serum hemoglobin, C-reactive peptide (CRP), ferritin, vitamin B12, folate, total protein, and albumin levels, serum neutrophil, monocyte, lymphocyte, eosinophil, and platelet counts, and mean corpuscular volume, mean platelet volume and platelet distribution width variables were examined. The patients were divided into HP-negative and HP-positive groups, and statistical analysis was performed between the two groups.

RESULTS: Among all patients, HP infection was seen in 24 (16%) patients. There was no difference between HP-positive and HP-negative groups in terms of gender, age, Marsh scores, serologic test levels, platelet, lymphocyte, neutrophil counts, CRP, vitamin B12, and folate levels. The anemia rate of HP-negative patients was 32.54%, HP-positive patients' rate was found to be significantly higher at 79.17% (p<0.001). The ferritin median of HP-negative patients was 41.49 (1-1441) and 13 (2.4-22) for HP-positive patients (p<0.001).

CONCLUSIONS: Anemia rates were 6.8-fold higher in HP-positive celiac patients. Celiac disease patients with anemia should have HP infection on their list of possible causes, especially in patients with refractory anemia.