title: Very high rate of misdiagnosis of celiac disease in clinical practice.
abstract: 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.
authors.affiliation: Small Bowel Section, Department of Medicine, "Dr Carlos Bonorino Udaondo" Gastroenterology Hospital, Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: María Inés
authors.initials: MI
authors.lastname: Pinto Sánchez
authors.forename: Edgardo
authors.initials: E
authors.lastname: Smecuol
authors.forename: Horacio
authors.initials: H
authors.lastname: Vázquez
authors.forename: Roberto
authors.initials: R
authors.lastname: Mazure
authors.forename: Eduardo
authors.initials: E
authors.lastname: Mauriño
authors.forename: Julio César
authors.initials: JC
authors.lastname: Bai
mesh_terms: 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