Shortness of Breath: Anyone Consider the Gut?Ayesha Kanwal1*, Imran Sheikh1, Raja R Shekhar Sappati Biyyani2, Corey Sievers2 and Annette Kyprianou2
1Division of Hospital Medicine, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio 44109, USA
2Division of Gastroenterology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio 44109, USA
- *Corresponding Author:
- Ayesha Kanwal DO
Division of Hospital Medicine
MetroHealth Medical Center
Case Western Reserve University
Cleveland, Ohio 44109, USA
Tel: 817 703 8671
Received date: October 17, 2011; Accepted date: June 25, 2012; Published date: June 28, 2012
Citation: Kanwal A, Sheikh I, Sappati Biyyani RRS, Sievers C, Kyprianou A (2012) Shortness of Breath: Anyone Consider the Gut?. J Gastroint Dig Syst 2:115. doi: 10.4172/2161-069X.1000115
Copyright: © 2012 Kanwal A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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.