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Ianiro G, Bibbò S, Bruno G, et al. Prior Misdiagnosis of Celiac Disease Is Common Among Patients Referred to a Tertiary Care Center: A Prospective Cohort Study. Clin Transl Gastroenterol. 2016;7:e139doi: 10.1038/ctg.2015.48.
Ianiro, G., Bibbò, S., Bruno, G., Ricci, R., Arena, V., Gasbarrini, A., & Cammarota, G. (2016). Prior Misdiagnosis of Celiac Disease Is Common Among Patients Referred to a Tertiary Care Center: A Prospective Cohort Study. Clinical and translational gastroenterology, 7e139. https://doi.org/10.1038/ctg.2015.48
Ianiro, Gianluca, et al. "Prior Misdiagnosis of Celiac Disease Is Common Among Patients Referred to a Tertiary Care Center: A Prospective Cohort Study." Clinical and translational gastroenterology vol. 7 (2016): e139. doi: https://doi.org/10.1038/ctg.2015.48
Ianiro G, Bibbò S, Bruno G, Ricci R, Arena V, Gasbarrini A, Cammarota G. Prior Misdiagnosis of Celiac Disease Is Common Among Patients Referred to a Tertiary Care Center: A Prospective Cohort Study. Clin Transl Gastroenterol. 2016 Jan 28;7:e139. doi: 10.1038/ctg.2015.48. PMID: 26821194; PMCID: PMC4737868.
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Clin Transl Gastroenterol. 2016 Jan 28;7:e139. doi: 10.1038/ctg.2015.48.

Prior Misdiagnosis of Celiac Disease Is Common Among Patients Referred to a Tertiary Care Center: A Prospective Cohort Study.

Clinical and translational gastroenterology

Gianluca Ianiro, Stefano Bibbò, Giovanni Bruno, Riccardo Ricci, Vincenzo Arena, Antonio Gasbarrini, Giovanni Cammarota

Affiliations

  1. Internal Medicine, Gastroenterology and Liver Unit, "A. Gemelli" University Hospital, Catholic University of Sacred Heart, Rome, Italy.
  2. Hystopathology Unit, "A. Gemelli" University Hospital, Catholic University of Sacred Heart, Rome, Italy.

PMID: 26821194 PMCID: PMC4737868 DOI: 10.1038/ctg.2015.48

Abstract

OBJECTIVES: Interest of patients and physicians in celiac disease is growing worldwide, but without a corresponding increase in the awareness of the disease. Many patients are diagnosed as celiacs even without completing the whole diagnostic process, with consequent risk of misdiagnosis and delay in the evaluation of other diseases. The objective of this study was to assess the rates of prior celiac disease misdiagnosis among patients referred to a tertiary care center.

METHODS: From June 2013 to December 2014, we prospectively recruited patients referred for the first time to our Celiac Disease Center. Patients with a previous diagnosis of celiac disease underwent a diagnostic revaluation by second reading of duodenal tissue slides, dosage of specific antibodies, and/or duodenal biopsy sampling; HLA status was investigated in pertinent cases.

RESULTS: A total of 198 subjects were recruited. Of these, 91 "naïve" patients (46%) started the diagnostic screening for celiac disease; 58 of them (64-29% of the whole sample) were diagnosed as celiacs. The remaining 107 patients (54%) came with a previous diagnosis of celiac disease: of these, 52 (49-26% of the whole sample) presented with confirmed diagnosis of celiac disease, whereas 55 (51-28% of the whole sample) underwent diagnostic revaluation. After the reassessment, diagnosis was rejected in 43 cases (78-22% of the whole sample) and confirmed in the remaining 12 (22-6% of the whole sample). Overall, diagnosis was confirmed in only 64 of the 107 subjects with a previous diagnosis (60-32% of the whole sample). Diagnosis of celiac disease was more frequently confirmed in "naïve" patients compared those with a questionable previous diagnosis (64% vs. 22%; P<0.0001).

CONCLUSIONS: A considerable number of patients referred to a tertiary care center are inaccurately diagnosed with celiac disease. Although we cannot exclude that uncertain diagnosis was a reason for the referral, we suggest greater adherence to guidelines to minimize the burden of celiac disease misdiagnosis.

References

  1. Gastroenterology. 2006 Apr;130(5):1466-79 - PubMed
  2. Aliment Pharmacol Ther. 2010 Jan;31(1):73-81 - PubMed
  3. Gastroenterology. 2005 Apr;128(4 Suppl 1):S57-67 - PubMed
  4. Clin Exp Gastroenterol. 2014 Jan 24;7:25-37 - PubMed
  5. Can J Gastroenterol. 2009 Aug;23(8):543-5 - PubMed
  6. Soc Sci Med. 2009 Aug;69(4):623-31 - PubMed
  7. Eur J Gastroenterol Hepatol. 1999 Oct;11(10):1185-94 - PubMed
  8. Intern Emerg Med. 2014 Apr;9(3):249-56 - PubMed
  9. Scand J Gastroenterol. 2008;43(11):1311-4 - PubMed
  10. Int J Immunopathol Pharmacol. 2009 Jan-Mar;22(1):1-7 - PubMed
  11. Am J Gastroenterol. 2013 May;108(5):656-76; quiz 677 - PubMed
  12. Acta Gastroenterol Latinoam. 2009 Dec;39(4):250-3 - PubMed
  13. Am J Gastroenterol. 2007 Jul;102(7):1461-3 - PubMed
  14. Am J Gastroenterol. 2010 Dec;105(12):2520-4 - PubMed
  15. Scand J Gastroenterol. 1997 Sep;32(9):917-9 - PubMed
  16. BMC Med. 2012 Feb 07;10:13 - PubMed
  17. Ann Med. 2010 Dec;42(8):557-61 - PubMed
  18. Gut. 2014 Aug;63(8):1210-28 - PubMed
  19. Gastroenterology. 2006 Apr;130(5):1480-91 - PubMed
  20. US News World Rep. 2008 Dec 1-8;145(12):66, 68 - PubMed
  21. World J Gastroenterol. 2013 Dec 14;19(46):8562-70 - PubMed
  22. Aliment Pharmacol Ther. 2007 Nov 1;26(9):1217-25 - PubMed
  23. BMC Med. 2014 May 23;12:85 - PubMed

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