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Original Article
Online Published: 27 Jun 2026
 


Celiac Disease in Children with Refractory Iron Deficiency Anemia: A prospective observational Study

Samrat Chirag Singh, Sanjeev Kumar Verma, Manisha Verma, Prerna Priyadarshini, Nishant Verma, Preeti Agrawal, Raj Kumar Kalyan, Sanjay Mishra, Mohammad Kaleem Ahmad.


Abstract
Celiac disease (CD) is an immune mediated enteropathy triggered by dietary gluten in genetically susceptible individuals. Refractory iron deficiency anaemia (RIDA) may be the sole presentation of CD in children. This study aimed to investigate the prevalence of celiac disease in this group of patients.
This prospective observational study was conducted over a period of one year at tertiary care centre of North India. Children aged 6 months to 14 years with refractory IDA were enrolled. Those with positive serology for celiac disease underwent upper gastrointestinal endoscopy and histopathological examination.
Out of 65 enrolled RIDA cases, prevalence of celiac disease was 23.0% (15/65). Significantly higher proportion of celiac RIDA had stunting (93.3% vs. 44.0%) and wasting (93.3% vs. 40.0%) as compared to undifferentiated RIDA. Clinical features like lethargy, refusal to feed, vomiting, chronic diarrhoea, failure to thrive, short stature and abdominal distention was more frequent in Celiac RIDA cases. Anti TTG levels between Celiac RIDA cases and undifferentiated RIDA cases was found to be statistically significant (p value<0.001). Abnormal endoscopic findings were observed in 15 out of 23 cases (65.21%) consistent with CD while the rest 8 (34.78 %) had normal UGIE findings.
A significant proportion of children with refractory IDA have underlying celiac disease, often without classical gastrointestinal manifestations. This significant prevalence value justifies the practice of testing patients with RIDA for celiac disease.

Key words: Celiac disease, Refractory Iron Deficiency Anemia, anti TTG antibodies


 
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How to Cite this Article
Pubmed Style

Singh SC, Verma SK, Verma M, Priyadarshini P, Verma N, Agrawal P, Kalyan RK, Mishra S, Ahmad MK. Celiac Disease in Children with Refractory Iron Deficiency Anemia: A prospective observational Study. Sudan J Paed. Online First: 27 Jun, 2026. doi:10.24911/SJP.106-1777780907

Web Style

Singh SC, Verma SK, Verma M, Priyadarshini P, Verma N, Agrawal P, Kalyan RK, Mishra S, Ahmad MK. Celiac Disease in Children with Refractory Iron Deficiency Anemia: A prospective observational Study. https://sudanjp.com//?mno=319511 [Access: June 27, 2026]. doi:10.24911/SJP.106-1777780907

AMA (American Medical Association) Style

Singh SC, Verma SK, Verma M, Priyadarshini P, Verma N, Agrawal P, Kalyan RK, Mishra S, Ahmad MK. Celiac Disease in Children with Refractory Iron Deficiency Anemia: A prospective observational Study. Sudan J Paed. Online First: 27 Jun, 2026. doi:10.24911/SJP.106-1777780907


Vancouver/ICMJE Style

Singh SC, Verma SK, Verma M, Priyadarshini P, Verma N, Agrawal P, Kalyan RK, Mishra S, Ahmad MK. Celiac Disease in Children with Refractory Iron Deficiency Anemia: A prospective observational Study. Sudan J Paed, [cited June 27, 2026]; Online First: 27 Jun, 2026. doi:10.24911/SJP.106-1777780907


Harvard Style

Singh, S. C., Verma, . S. K., Verma, . M., Priyadarshini, . P., Verma, . N., Agrawal, . P., Kalyan, . R. K., Mishra, . S. & Ahmad, . M. K. (0) Celiac Disease in Children with Refractory Iron Deficiency Anemia: A prospective observational Study. Sudan J Paed, Online First: 27 Jun, 2026. doi:10.24911/SJP.106-1777780907


Turabian Style

Singh, Samrat Chirag, Sanjeev Kumar Verma, Manisha Verma, Prerna Priyadarshini, Nishant Verma, Preeti Agrawal, Raj Kumar Kalyan, Sanjay Mishra, and Mohammad Kaleem Ahmad. 0. Celiac Disease in Children with Refractory Iron Deficiency Anemia: A prospective observational Study. Sudanese Journal of Paediatrics, Online First: 27 Jun, 2026. doi:10.24911/SJP.106-1777780907


Chicago Style

Singh, Samrat Chirag, Sanjeev Kumar Verma, Manisha Verma, Prerna Priyadarshini, Nishant Verma, Preeti Agrawal, Raj Kumar Kalyan, Sanjay Mishra, and Mohammad Kaleem Ahmad. "Celiac Disease in Children with Refractory Iron Deficiency Anemia: A prospective observational Study." Sudanese Journal of Paediatrics Online First: 27 Jun, 2026. doi:10.24911/SJP.106-1777780907


MLA (The Modern Language Association) Style

Singh, Samrat Chirag, Sanjeev Kumar Verma, Manisha Verma, Prerna Priyadarshini, Nishant Verma, Preeti Agrawal, Raj Kumar Kalyan, Sanjay Mishra, and Mohammad Kaleem Ahmad. "Celiac Disease in Children with Refractory Iron Deficiency Anemia: A prospective observational Study." Sudanese Journal of Paediatrics Online First: 27 Jun, 2026. Web. 27 Jun 2026 doi:10.24911/SJP.106-1777780907


APA (American Psychological Association) Style

Singh, S. C., Verma, . S. K., Verma, . M., Priyadarshini, . P., Verma, . N., Agrawal, . P., Kalyan, . R. K., Mishra, . S. & Ahmad, . M. K. (0) Celiac Disease in Children with Refractory Iron Deficiency Anemia: A prospective observational Study. Sudanese Journal of Paediatrics, Online First: 27 Jun, 2026. doi:10.24911/SJP.106-1777780907




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