{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:36:34Z","timestamp":1787070994135,"version":"build-2736575974"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T00:00:00Z","timestamp":1757376000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims:<\/jats:title>\n                    <jats:p>The aim is to assess the usefulness of routine duodenal biopsy in patients presenting with iron deficiency anemia in areas with low prevalence of celiac disease (CD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This prospective study included 156 patients with unexplained iron deficiency anemia, referred to the Department of Gastroenterology. JSS Medical College and Hospital, Mysuru, India. All patients underwent upper gastrointestinal (GI) endoscopy and duodenal biopsy. Histopathological changes were assessed according to the Marsh classification. Celiac disease was defined as having Marsh II or above on histopathology or being seropositive with Marsh I histopathology and having a good response to gluten-free diet. Furthermore, patients were evaluated for Immunoglobulin A (IgA) anti-tissue transglutaminase (t-TG) antibody with enzyme-linked immunosorbent assay technique.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>One hundred and fifty-six patients were included in the study with a mean age of 52.17 \u00b1 16.01 (67.7% of females) who underwent endoscopic duodenal biopsy. Three (1.9%) were diagnosed to have CD on biopsy, which was confirmed with a serological test (IgA Anti t-Tg). Positivity for CD did not correlate with the severity of anemia or GI symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Celiac disease should be considered in patients presenting with unexplained iron deficiency anemia, even if not accompanied by GI symptoms. Doing initial serological testing followed by duodenal biopsy may be an appropriate approach, especially in areas with a low prevalence of celiac disease. Routine duodenal biopsies did not seem a reasonable approach considering cost-effectiveness and its clinical utility.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/aam.aam_30_25","type":"journal-article","created":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T11:00:12Z","timestamp":1757415612000},"page":"95-98","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Role of Routine Duodenal Biopsy in Patients with Unexplained Iron Deficiency Anemia in Areas of Low Prevalence of Celiac Disease"],"prefix":"10.4103","volume":"25","author":[{"given":"Abhishek","family":"Kabra","sequence":"first","affiliation":[{"name":"Department of Medical Gastroenterology, JSS Medical College and Hospital, JSS AHER, Mysore, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aradya","family":"Venu","sequence":"additional","affiliation":[{"name":"Department of Medical Gastroenterology, JSS Medical College and Hospital, JSS AHER, Mysore, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"CS","family":"Sheeladevi","sequence":"additional","affiliation":[{"name":"Department of Pathology, JSS Medical College and Hospital, JSS AHER, Mysore, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepak","family":"Suvarna","sequence":"additional","affiliation":[{"name":"Department of Medical Gastroenterology, JSS Medical College and Hospital, JSS AHER, Mysore, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. P.","family":"Nandeesh","sequence":"additional","affiliation":[{"name":"Department of Medical Gastroenterology, JSS Medical College and Hospital, JSS AHER, Mysore, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devansh","family":"Bajaj","sequence":"additional","affiliation":[{"name":"Department of Medical Gastroenterology, JSS Medical College and Hospital, JSS AHER, Mysore, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,9,9]]},"reference":[{"issue":"Suppl 1","key":"R1-20260109","first-page":"19","article-title":"Mechanisms and management of iron deficiency anaemia","volume":"105","author":"Provan","year":"1999","journal-title":"Br J Haematol"},{"key":"R2-20260109","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1136\/bmj.314.7077.360","article-title":"ABC of clinical haematology. Iron deficiency anaemia","volume":"314","author":"Frewin","year":"1997","journal-title":"BMJ"},{"key":"R3-20260109","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1016\/S1590-8658(03)00067-7","article-title":"The stomach and iron deficiency anaemia: A forgotten link","volume":"35","author":"Annibale","year":"2003","journal-title":"Dig Liver Dis"},{"key":"R4-20260109","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1111\/j.1572-0241.2001.03463.x","article-title":"Efficacy of gluten-free diet alone on recovery from iron deficiency anemia in adult celiac patients","volume":"96","author":"Annibale","year":"2001","journal-title":"Am J Gastroenterol"},{"key":"R5-20260109","first-page":"227","article-title":"[Iron deficiency: Not always blood losses]","volume":"20","author":"Alonso","year":"2003","journal-title":"An Med Interna"},{"key":"R6-20260109","doi-asserted-by":"crossref","first-page":"1280","DOI":"10.1080\/00365529850172368","article-title":"Undiagnosed coeliac disease is common in Finnish adults","volume":"33","author":"Kolho","year":"1998","journal-title":"Scand J Gastroenterol"},{"key":"R7-20260109","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1111\/j.1651-2227.1996.tb14244.x","article-title":"The coeliac iceberg in Italy. A multicentre antigliadin antibodies screening for coeliac disease in school-age subjects","volume":"412","author":"Catassi","year":"1996","journal-title":"Acta Paediatr Suppl"},{"key":"R8-20260109","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1097\/01.meg.0000224477.51428.32","article-title":"Screening of the adult population in Iran for coeliac disease: Comparison of the tissue-transglutaminase antibody and anti-endomysial antibody tests","volume":"18","author":"Akbari","year":"2006","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"R9-20260109","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1038\/ajg.2015.398","article-title":"Prevalence of adult celiac disease in India: Regional variations and associations","volume":"111","author":"Ramakrishna","year":"2016","journal-title":"Am J Gastroenterol"},{"key":"R10-20260109","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1111\/j.1442-200x.2004.01986.x","article-title":"Celiac disease with various presentations","volume":"46","author":"Doganci","year":"2004","journal-title":"Pediatr Int"},{"key":"R11-20260109","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1182\/blood-2006-07-031104","article-title":"Hematologic manifestations of celiac disease","volume":"109","author":"Halfdanarson","year":"2007","journal-title":"Blood"},{"key":"R12-20260109","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1097\/01.SMJ.0000051059.23259.56","article-title":"Prevalence of occult celiac disease in patients with iron-deficiency anemia: A prospective study","volume":"97","author":"Karnam","year":"2004","journal-title":"South Med J"},{"key":"R13-20260109","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1111\/j.1572-0241.1999.983_f.x","article-title":"Sensitivity of antiendomysium and antigliadin antibodies in untreated celiac disease: Disappointing in clinical practice","volume":"94","author":"Rostami","year":"1999","journal-title":"Am J Gastroenterol"},{"issue":"Suppl 3-4","key":"R14-20260109","doi-asserted-by":"crossref","first-page":"V1","DOI":"10.1136\/gut.46.suppl_4.iv1","article-title":"Guidelines for the management of iron deficiency anaemia. British society of gastroenterology","volume":"46","author":"Goddard","year":"2000","journal-title":"Gut"},{"key":"R15-20260109","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1053\/j.gastro.2020.06.045","article-title":"AGA Technical Review on Gastrointestinal Evaluation of Iron Deficiency Anemia","volume":"159","author":"Rockey","year":"2020","journal-title":"Gastroenterology"},{"key":"R16-20260109","doi-asserted-by":"crossref","first-page":"7381","DOI":"10.3748\/wjg.14.7381","article-title":"Gluten sensitive enteropathy in patients with iron deficiency anemia of unknown origin","volume":"14","author":"Zamani","year":"2008","journal-title":"World J Gastroenterol"}],"container-title":["Annals of African Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/aam.aam_30_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:40:05Z","timestamp":1787067605000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/aam.aam_30_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,9]]},"references-count":16,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/aam.aam_30_25","relation":{},"ISSN":["1596-3519","0975-5764"],"issn-type":[{"value":"1596-3519","type":"print"},{"value":"0975-5764","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,9]]},"assertion":[{"value":"2025-01-22","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-25","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}