title: The impact of misdiagnosing celiac disease at a referral centre.
abstract: In the past few years, the number of celiac disease diagnoses not confirmed at the Fondazione IRCCS Policlinico San Matteo, Pavia, Italy, a tertiary referral centre, was particularly high. Therefore, a decision was made to investigate the reasons why these diagnoses were wrong and by whom they had been made. The clinical histories of all celiac patients referred to the centre were re-evaluated. Between December 1998 and January 2007, 614 patients who were diagnosed at other institutions and presumed to be affected by celiac disease attended the tertiary referral outpatient clinic. The histological and serological results allowed for confirmation the diagnosis in 434 patients. In the remaining 180 patients, the initial diagnosis of celiac disease could not be confirmed; therefore, the patients were re-investigated. After re-evaluation, the diagnosis of celiac disease was confirmed in only 61 of these 180 cases. The reasons for incorrect initial diagnosis were analyzed. A mere 80% correct diagnosis rate is a very disappointing result. Although it should be obvious that celiac disease must be investigated with duodenal biopsies and celiac antibody testing, this well-known strategy is not always followed, probably resulting in an incorrect diagnosis.
authors: Coeliac Centre/First Department of Internal Medicine, University of Pavia, Pavia, Italy. f.biagi@smatteo.pv.it
authors: Federico
authors: F
authors: Biagi
authors: Paola I
authors: PI
authors: Bianchi
authors: Jonia
authors: J
authors: Campanella
authors: Giovanni
authors: G
authors: Zanellati
authors: Gino R
authors: GR
authors: Corazza
mesh_terms: D000328:Adult; D000906:Antibodies / Q000032:analysis* / Q000276:immunology; D001706:Biopsy / Q000379:methods; D002446:Celiac Disease / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D003951:Diagnostic Errors; D004386:Duodenum / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000906:Antibodies