Clinical Relevance of Hematological Parameters and Hemogram-Derived Inflammatory Indices in Newly Diagnosed Pediatric Celiac Disease
Abstract
Background: Hematological abnormalities are common in celiac disease (CD), but the clinical value of hemogram-derived inflammatory indices in children remains uncertain.
Aim: To evaluate routine hematological parameters and hemogram-derived indices in newly diagnosed pediatric CD and assess their diagnostic and severity-related relevance.
Materials and methods: This retrospective comparative study included 97 children with biopsy-confirmed newly diagnosed CD and 97 age- and sex-comparable controls. Hematological parameters and derived indices were compared between groups. Patients with CD were stratified by tissue transglutaminase immunoglobulin A (tTG-IgA) level (<10× or ≥10× the upper limit of normal) and histopathological severity (Marsh 3A vs 3B–3C). False discovery rate correction, age- and sex-adjusted logistic regression, Spearman correlation, and receiver operating characteristic analyses were performed.
Results: Compared with controls, children with CD had reduced hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, and hemoglobin-to-red cell distribution width ratio, but increased red cell distribution width; these differences remained significant after correction. Hemogram-based inflammatory indices were not consistently related to diagnosis or disease severity. tTG-IgA levels ≥10× the upper limit of normal were associated with advanced villous atrophy (odds ratio, 3.85; 95% confidence interval, 1.23–12.03; p=0.033). Quantitative tTG-IgA levels did not correlate with hematological markers. The hemoglobin-to-red cell distribution width ratio had the highest but limited discriminatory performance (area under the curve, 0.658).
Conclusion: In newly diagnosed pediatric CD, hematological abnormalities are mainly erythrocyte-related, whereas hemogram-derived inflammatory indices have limited clinical value.
Keywords
Celiac disease, Child, Blood cell count, Biomarkers, Immunoglobulin A
Supporting Institution
This study received no financial support from any institution or organization.
Ethical Statement
The study was conducted in accordance with the Declaration of Helsinki and was approved by the Süleyman Demirel University Ethics Committee on 9 July 2026 (approval no. 126/18). Written informed consent was obtained from the parents or legal guardians of all participants, and assent was obtained from the children when appropriate.
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