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Question 1
Should children presenting with iron deficiency anaemia be screened for coeliac disease?
  1. Sara Winter1,
  2. Christina Halsey1,2
  1. 1Royal Hospital for Sick Children, Glasgow, UK
  2. 2Centre for Immunobiology, Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
  1. Correspondence to Dr Christina Halsey, Centre for Immunobiology, Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8TA, UK; chris.halsey{at}glasgow.ac.uk

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Scenario

A 9-year-old child is referred by the general practitioner to the general paediatric clinic with a haemoglobin (Hb) of 10.2 g/dL, mean cell volume (MCV) 72 fL and ferritin 9.8 µg/L. The child is otherwise well and reports no history of bleeding or gastrointestinal (GI) symptoms and has a good balanced diet. You decide to treat with a course of oral iron therapy but wonder if you should investigate now for coeliac disease (CD).

Structured clinical question

Patient: Child presenting with iron deficiency anaemia (IDA)

Intervention: Screening for CD

Outcome: Diagnosis of CD

In children presenting with IDA, is screening for CD worthwhile in the absence of GI symptoms?

Search

Embase, Medline and Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched (1946–May 2013) using the criteria ‘anaemia’, ‘iron deficiency’ and ‘coeliac disease’ limiting the results to ‘all child (0–18 years)’. These searches retrieved 58 individual articles, eight of which were considered relevant. The rest were excluded as irrelevant, adult studies or were single case reports or letters.

A further search of the above and tissue transglutaminase (tTG) antibody was carried out using Medline and Embase; this did not find any further relevant papers.

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Table 1

Coeliac disease …

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