Delay in diagnosis of celiac disease in patients without gastrointestinal complaints Journal Article

Local Library Link: Find It @ Loyola

Authors: Paez, M. A.; Gramelspacher, A. M.; Sinacore, J; Winterfield, L.; Venu, M
Article Title: Delay in diagnosis of celiac disease in patients without gastrointestinal complaints
Abstract: PURPOSE: The purpose of our study is to investigate the delay in diagnosis of patients with biopsy-proven celiac disease in those who present with gastrointestinal complaints vs non-gastrointestinal complaints at our tertiary care center. Celiac disease is an autoimmune disorder which affects approximately 1% of the population worldwide. Celiac disease can have variable clinical presentations characterized by either predominately gastrointestinal symptoms or may present without any gastrointestinal symptom. METHODS: We retrospectively reviewed 687 adult patients#39; charts who carried the diagnosis of celiac disease. Patients included had biopsy-proven celiac disease and were categorized based on presence or absence of gastrointestinal symptoms prior to their diagnosis. RESULTS: 101 patients with biopsy-proven celiac disease met inclusion criteria. 52 patients presented with gastrointestinal symptoms and 49 had non-gastrointestinal complaints. Results from Mann-Whitney statistical analysis showed a median delay in diagnosis of 2.3 months for gastrointestinal symptoms group and 42 months for non-gastrointestinal group ( Plt;0.001). 43.2% patients with non-gastrointestinal symptoms had abnormal thyroid-stimulating hormone (TSH) as opposed to 15.5% in the gastrointestinal symptom group (P=0.004). Of patients with non-gastrointestinal symptoms, 69.4% had anemia compared to 11.5% of gastrointestinal symptom group (Plt;0.001). The majority of patients in the non-gastrointestinal symptom group 68% were noted to have abnormal bone density scans compared to 41% in the gastrointestinal symptom group. No gender differences were noted on Chi square analysis between the two groups (p=0.997). CONCLUSIONS: Although there is growing awareness of celiac disease, the delay in diagnosis for patients without gastrointestinal symptoms remains prolonged, with an average delay of 3.5 years.
Journal Title: The American Journal of Medicine
ISSN: 1555-7162; 0002-9343
Publisher: Elsevier Inc  
Journal Place: United States
Date Published: 2017
Language: eng
DOI/URL:

S0002-9343(17)30606-X
Notes: LR: 20170617; CI: Copyright (c) 2017; JID: 0267200; OTO: NOTNLM; 2017/04/01 [received]; 2017/05/03 [revised]; 2017/05/04 [accepted]; aheadofprint