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CPE-004 · Safety
ID-CEL-01: Celiac and H. pylori consideration
Celiac and H. pylori consideration. Evaluates iron-deficiency anemia pattern, OR iron deficiency not responding to oral iron.
Condition
- iron-deficiency anemia pattern, OR iron deficiency not responding to oral iron
- celiac serology not documented
What it reports
- Consider celiac serology (tissue transglutaminase IgA with total IgA) and H. pylori testing
Diagnostic boundary
- Malabsorption is one cause among several.
Evidence
- EV-AGA-2020Ko CW, Siddique SM, Patel A, et al. AGA Clinical Practice Guidelines on the Gastrointestinal Evaluation of Iron Deficiency Anemia. Gastroenterology. 2020;159(3):1085-1094.Supports: A ferritin cutoff of 45 ng/mL is suggested to diagnose iron deficiency Bidirectional endoscopy is suggested for asymptomatic men and postmenopausal women with iron-deficiency anemia Celiac serology and H. pylori testing have a role in evaluation
- EV-ACG-CELIAC-2023Rubio-Tapia A, Hill ID, Semrad C, et al. American College of Gastroenterology Guidelines Update: Diagnosis and Management of Celiac Disease. Am J Gastroenterol. 2023;118(1):59-76.Supports: Celiac serology is appropriate in unexplained iron-deficiency anemia
Cases where this rule fires
Open a case to see this rule fire with real inputs, then change the values until it stops.
IRON-FX-01
Classic iron-deficiency anemia in a premenopausal woman
A 34-year-old with heavy periods, Hb 9.8, MCV 72 and a ferritin of 6.
IRON-FX-03
Iron-deficiency anemia in a man
A 61-year-old man with Hb 10.9, MCV 76 and a ferritin of 9.
IRON-FX-04
Iron-deficiency anemia after menopause
A 67-year-old woman, postmenopausal, Hb 10.6, ferritin 11.
IRON-FX-06
Inflammation with ferritin 48 and TSAT 9
Ferritin looks near normal but sits under the WHO inflammation cutoff of 70.
IRON-FX-09
Heart failure with ferritin 180 and TSAT 14
Ferritin 100–299 with low saturation meets the heart-failure definition.
IRON-FX-13
Severe anemia
Hemoglobin 6.4 g/dL with a ferritin of 4.
IRON-FX-14
Anemia with overt gastrointestinal bleeding
Black stools and Hb 8.9.
IRON-FX-17
Iron-deficiency anemia in pregnancy
A pregnant woman with Hb 10.2 and a ferritin of 11.
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