Hematologic Manifestations of Celiac Disease

Celiac disease is a systemic disease, which is associated with a number of hematologic manifestations. Individuals can present with hematological abnormalities even prior to the diagnosis of celiac disease. Anemia secondary to iron, folic acid and vitamin B12 malabsorption is a common complication of celiac disease. Patients can also present with thrombocytosis, thrombocytopenia, leukopenia, venous thromboembolism, hyposplenism and IgA deficiency. Celiac disease also predisposes to lymphoma development. The highest risk is for enteropathy associated T-cell lymphoma (EATL), an aggressive lymphoma with poor prognosis, however an increased risk for B-cell lymphomas and extraintestinal lymphomas has been described. Strict adherence to a gluten-free diet is known to decrease the risk of lymphomas.