Prevalence of Celiac Disease in Omani Adults with Iron Deficiency Anemia of Unknown Cause

Objectives: This study aimed to estimate the serological prevalence of celiac disease in patients with IDA of unknown cause at primary health care facility. Methods: This is a prospective case finding study that was conducted at the primary care clinics in the Sultan Qaboos University Hospital (SQUH) from September 2018 to June 2020. A total of 104 patients aged 18 to 55 years old, with a hemoglobin (Hb) level less than 11.5 g/dl for males and less than 11.0 g/dl for females and a ferritin level less than 30 ng/mL for males and less than 13 ng/mL for females participated in the study. Blood samples were obtained for an initial serological screen using serum IgA level and then those with normal level of IgA, had IgA- Anti-tissue transglutaminase antibody (tTG) and IgA- anti-deamidated gliadin peptide (DGP). Positive IgA-tTG test was confirmed using IgA-endomysial antibodies. Patients with low IgA level were tested using IgG-tTG and IgG-DGP. Results: Eight patients out of the 104 (7.7%) found to have positive serological screening for celiac disease. Three patients out of the eight (37.5%) had a positive IgA tTG. Two of those three (66.7%) had a positive IgA-endomysial antibody as well. The IgA-DGP was positive in seven patients out of the 104 (6.7 %). Out of those seven patients, two also had a positive IgA tTG. Conclusion: Celiac disease is not a rare disorder. There is a need to increase awareness among healthcare professionals about celiac disease and its non-classical manifestations such as IDA.Keywords: cervical smears, conventional slides, ThinPrep slides, cervical organisms.