Very high rate of misdiagnosis of celiac disease in clinical practice.
OBJECTIVE
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
Our study detected a high rate of histopathological and serological misdiagnosis of CD in community practice which may have profound negative impact on patients.
Pinto Sánchez
María Inés
MI
Small Bowel Section, Department of Medicine, "Dr Carlos Bonorino Udaondo" Gastroenterology Hospital, Ciudad Autónoma de Buenos Aires, Argentina.
Smecuol
Edgardo
E
Vázquez
Horacio
H
Mazure
Roberto
R
Mauriño
Eduardo
E
Bai
Julio César
JC
D001706:Biopsy; D002446:Celiac Disease / Q000175:diagnosis* / Q000473:pathology; D002983:Clinical Competence; D003951:Diagnostic Errors; D005194:Family Practice; D006801:Humans; D010338:Pathology, Clinical; D012017:Referral and Consultation; D012189:Retrospective Studies