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Jost, PJ; Stengel, SM; Huber, W; Sarbia, M; Peschel, C; Duyster, J.
Very severe iron-deficiency anemia in a patient with celiac disease and bulimia nervosa: a case report.
Int J Hematol. 2005; 82(4):310-311 Doi: 10.1532/IJH97.E0505 (- Case Report)
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Jost Philipp

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A 29-year-old woman presented to the emergency department with exhaustion, fatigue, and abdominal pain. She reported having received a diagnosis of bulimia nervosa 10 years before. On examination, she had a marked pallor and was severely malnourished. Laboratory analysis revealed a dramatically low hemoglobin level of 1.7 g/dL (ref: 11.5-15.8 g/dL). Serum iron was quantified as 1.4 micromol/L (ref: 7-26 micromol/L), ferritin as 5 ng/mL (ref: 10-120 ng/mL), and the level of serum transferrin as 212 mg/dL (ref: 200-360 mg/dL). A duodenal biopsy revealed villous atrophy in the mucosal layer indicative for celiac disease. This diagnosis was confirmed by serum levels of endomysial antibodies, tissue transglutaminase antibody, and antigliadin antibodies. The newly diagnosed gluten-sensitive enteropathy is likely to be in part responsible for the severe symptoms reported. The extent of hemoglobin decline in combination with an astonishing lack of critical symptoms seen in this patient is a rarity. We conclude that anorectic patients with severe anemia and malnutrition should be evaluated for the presence of additional somatic conditions.
Find related publications in this database (using NLM MeSH Indexing)
Adult -
Anemia, Iron-Deficiency - blood
Anemia, Iron-Deficiency - etiology
Anemia, Iron-Deficiency - therapy
Blood Coagulation -
Blood Transfusion -
Bulimia Nervosa - blood
Bulimia Nervosa - etiology
Bulimia Nervosa - therapy
Celiac Disease - blood
Celiac Disease - diagnosis
Celiac Disease - etiology
Celiac Disease - therapy
Female -
Ferritins - blood
Hematocrit -
Humans -
Iron - blood
Nutritional Physiological Phenomena -
Transferrin - metabolism

Find related publications in this database (Keywords)
iron deficiency
bulimia nervosa
celiac disease
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