Background: Patients suffering from non-celiac wheat sensitivity (NCWS) frequently report extra- intestinal symptoms, such as anemia. Aims: We investigated the prevalence and associated clinical features of anemia in NCWS patients. Methods: Data from 244 NCWS patients, diagnosed by double-blind placebo-controlled wheat challenge, were retrospectively reviewed and compared with 2 control groups (celiac disease (CD) and irritable bowel syndrome (IBS)). Furthermore, 31 NCWS anemic patients were prospectively re-evaluated after at least 12 months on the “strict”wheat-free diet (WFD). Results: Anemia prevalence in NCWS patients was 34.8% (mean hemoglobin 10.4 ±1.4 g/dl), significantly higher than in IBS (17.4%, P = 0.03), but not in CD ones. The NCWS group, on the whole, had sideropenic- like features with low serum iron and altered iron deposits. Both anemia prevalence and sideropenic-like features were more evident in CD than in NCWS patients, whereas only a few IBS subjects showed such features. Significant differences were found in anemic vs non-anemic NCWS patients as regards to female sex, diagnostic delay, poly/hypermenorrhea, iron deficiency, and higher TSH values. A long-term WFD significantly reduced anemia and improved iron metabolism. Conclusion: Microcytic/hypochromic anemia and altered iron metabolism occur frequently in NCWS and can be treated with a long-term strict WFD. NCWS should be included in differential diagnosis of anemic patients with “functional gastrointestinal troubles”.

Mansueto, P., Seidita, A., Soresi, M., Giuliano, A., Riccio, G., Volta, U., et al. (2022). Anemia in non-celiac wheat sensitivity: Prevalence and associated clinical and laboratory features. DIGESTIVE AND LIVER DISEASE [10.1016/j.dld.2022.11.022].

Anemia in non-celiac wheat sensitivity: Prevalence and associated clinical and laboratory features

Mansueto, Pasquale;Seidita, Aurelio;Soresi, Maurizio;Giuliano, Alessandra;Riccio, Giorgia;La Blasca, Francesco;Carroccio, Antonio
2022-12-17

Abstract

Background: Patients suffering from non-celiac wheat sensitivity (NCWS) frequently report extra- intestinal symptoms, such as anemia. Aims: We investigated the prevalence and associated clinical features of anemia in NCWS patients. Methods: Data from 244 NCWS patients, diagnosed by double-blind placebo-controlled wheat challenge, were retrospectively reviewed and compared with 2 control groups (celiac disease (CD) and irritable bowel syndrome (IBS)). Furthermore, 31 NCWS anemic patients were prospectively re-evaluated after at least 12 months on the “strict”wheat-free diet (WFD). Results: Anemia prevalence in NCWS patients was 34.8% (mean hemoglobin 10.4 ±1.4 g/dl), significantly higher than in IBS (17.4%, P = 0.03), but not in CD ones. The NCWS group, on the whole, had sideropenic- like features with low serum iron and altered iron deposits. Both anemia prevalence and sideropenic-like features were more evident in CD than in NCWS patients, whereas only a few IBS subjects showed such features. Significant differences were found in anemic vs non-anemic NCWS patients as regards to female sex, diagnostic delay, poly/hypermenorrhea, iron deficiency, and higher TSH values. A long-term WFD significantly reduced anemia and improved iron metabolism. Conclusion: Microcytic/hypochromic anemia and altered iron metabolism occur frequently in NCWS and can be treated with a long-term strict WFD. NCWS should be included in differential diagnosis of anemic patients with “functional gastrointestinal troubles”.
Settore MED/09 - Medicina Interna
Mansueto, P., Seidita, A., Soresi, M., Giuliano, A., Riccio, G., Volta, U., et al. (2022). Anemia in non-celiac wheat sensitivity: Prevalence and associated clinical and laboratory features. DIGESTIVE AND LIVER DISEASE [10.1016/j.dld.2022.11.022].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10447/577588
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