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Blood, 15 January 2007, Vol. 109, No. 2, pp. 412-421.
Prepublished online as a Blood First Edition Paper on September 14, 2006; DOI 10.1182/blood-2006-07-031104.
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Submitted July 19, 2006
Accepted August 19, 2006
Hematological manifestations of celiac disease
Thorvardur R Halfdanarson, Mark R. Litzow, and Joseph A Murray*
Division of Hematology & Division of Gastroenterology Mayo Clinic College of Medicine, Rochester, MN
* Corresponding author; email: murray.joseph{at}mayo.edu.
Celiac disease is a common systemic disorder which can have multiple hematological manifestations. Patients with celiac disease may present to hematologists for evaluation of various hematological problems prior to receiving a diagnosis of celiac disease. Anemia secondary to malabsorption of iron, folic acid and or vitamin B12 is a common complication of celiac disease and many patients present with anemia or have anemia at the time of diagnosis. Celiac disease may also be associated with thrombocytosis, thrombocytopenia, leukopenia, venous thromboembolism, hyposplenism and IgA deficiency. Patients with celiac disease are at increased risk of being diagnosed with lymphoma, especially of the T-cell type. The risk is highest for enteropathy-type T-cell lymphoma (ETL) and B-cell lymphoma of the gut but extraintestinal lymphomas can also be seen. ETL is an aggressive disease with poor prognosis but strict adherence to a gluten free diet may prevent its occurrence.
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