胃腸および消化器系

抽象的な

Shortness of Breath: Anyone Consider the Gut?

Ayesha Kanwal, Imran Sheikh, Raja R Shekhar Sappati Biyyani, Corey Sievers and Annette Kyprianou

Dyspnea is a common complaint that compels patients to seek medical care. Usual etiologies include asthma, chronic obstructive pulmonary disease, myocardial dysfunction and pulmonary embolus. In our case a patient was admitted to our hospital with dyspnea, fatigue and pleuritic chest pain for three weeks. Physical examination and imaging were unremarkable. Labs were only significant for severe microcytic anemia with hemoglobin 2.8 g/dL, hematocrit of 12%, MCV 56, iron <6 mcg/dL, and ferritin 13.9 ng/mL. All the usual causes of iron deficiency anemia were ruled out and patient was diagnosed with celiac disease. The incidence of celiac disease in patients with iron deficiency anemia has been reported to be from 6% to 12%. Among patients whose anemia does not respond to iron therapy the incidence increases to 20%. This case illustrates that when a patient with common complaints of dyspnea and anemia is evaluated celiac disease should always be considered in the differential.