Impact of delay in the diagnosis on the severity of celiac disease

© 2023 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd..

BACKGROUND AND AIM: Celiac disease (CeD) has now become a global disease with a worldwide prevalence of 0.67%. Despite being a common disease, CeD is often not diagnosed and there is a significant delay in its diagnosis. We reviewed the impact of the delay in the diagnosis on the severity of manifestations of CeD.

METHODS: We reviewed clinical records of 726 consecutive patients with CeD from the Celiac Clinic database and the National Celiac Disease Consortium database. We extracted specific data including the demographics, symptoms at presentation, time of onset of symptoms, time to diagnosis from the onset of the symptoms, and relevant clinical data including fold-rise in anti-tissue transglutaminase antibody (IgA anti-tTG Ab) and severity of villous and crypt abnormalities as assessed using modified Marsh classification.

RESULTS: The median duration between the onset of symptoms and the diagnosis of CeD was 27 months (interquartile range 12-60 months). A longer delay in the diagnosis of CeD from the onset of symptoms was associated with lower height for age, lower hemoglobin, higher fold rise in IgA Anti tTG titers, and higher severity of villous and crypt abnormalities. About 18% of patients presented with predominantly non-gastrointestinal complaints and had a longer delay in the diagnosis of CeD.

CONCLUSIONS: There is a significant delay in the diagnosis of CeD since the onset of its symptoms. The severity of celiac disease increases with increasing delay in its diagnosis. There is a need to keep a low threshold for the diagnosis of CeD in appropriate clinical settings.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:39

Enthalten in:

Journal of gastroenterology and hepatology - 39(2024), 2 vom: 15. Feb., Seite 256-263

Sprache:

Englisch

Beteiligte Personen:

Mehta, Shubham [VerfasserIn]
Agarwal, Ankit [VerfasserIn]
Pachisia, Aditya Vikram [VerfasserIn]
Singh, Alka [VerfasserIn]
Dang, Sana [VerfasserIn]
Vignesh, Dwarakanathan [VerfasserIn]
Ahmed, Anam [VerfasserIn]
Chaudhari, Bodhisattya Roy [VerfasserIn]
Prasad, Shubham [VerfasserIn]
Goyal, Ritik Mahaveer [VerfasserIn]
Chavan, Amitkumar [VerfasserIn]
Singh, Aagamjit [VerfasserIn]
Kumar, Sanjay [VerfasserIn]
Sharma, Divya [VerfasserIn]
Chauhan, Ashish [VerfasserIn]
Rajput, Mahendra Singh [VerfasserIn]
Rajput, Sachin [VerfasserIn]
Das, Prasenjit [VerfasserIn]
Falodia, Sushil [VerfasserIn]
Sinha, Saroj Kant [VerfasserIn]
Kochhar, Rakesh [VerfasserIn]
Ahuja, Vineet [VerfasserIn]
Makharia, Govind K [VerfasserIn]

Links:

Volltext

Themen:

Anemia
Autoantibodies
EC 2.3.2.13
Height
Hemoglobin
Hemoglobins
Immunoglobulin A
Journal Article
Review
Serology
Short stature
Transglutaminases
Villous atrophy

Anmerkungen:

Date Completed 15.02.2024

Date Revised 15.02.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1111/jgh.16385

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM364550678