Very high rate of misdiagnosis of celiac disease in clinical practice
Pinto Sánchez, M.ía.I.és.; Smecuol, E.; Vázquez, H.; Mazure, R.; Mauriño, E.; Bai, J.C.és.
Acta Gastroenterologica Latinoamericana 39(4): 250-253
2009
ISSN/ISBN: 0300-9033 PMID: 20178253 Document Number: 632089
We evaluated the accuracy of the diagnosis of celiac disease (CD) performed in the community clinical setting compared with that of an academic experienced center. Original biopsy slides and reports used for diagnosis in the community setting and the CD serology were revised in 70 consecutive patients attending our institution for a second opinion. An expert team determined the final diagnosis unaware of the original consideration. The poor quality of samples made histology assessment by the expert pathologist uncertain in 8.7% of slides with CD external diagnosis. We detected a divergent diagnosis between the two practice settings in 46.3% of available cases with a significant overdiagnosis of CD in the community (p < 0.0001). Congruent serology results were demonstrated in 72.2% of cases. Our study detected a high rate of histopathological and serological misdiagnosis of CD in community practice which may have profound negative impact on patients.