Celiac disease is a substantially underdiagnosed disorder, with clinical testing currently guided by case finding.
Dr Hujoel and colleagues determined the presence of indications for diagnostic testing and frequency of clinical testing in undiagnosed celiac disease.
The team performed a case‐control study of adults without prior diagnosis of celiac disease.
Undiagnosed cases were identified through sequential serology, and unaffected age‐ and gender‐matched controls were selected.
Medical records were systematically reviewed for indications for and evidence of clinical testing.
|Cases of undiagnosed celiac disease were more likely to develop osteoporosis|
|Alimentary Pharmacology & Therapeutics|
Of 47,557 adults, 408 cases of undiagnosed celiac disease were identified.
The team selected 408 serology negative matched controls.
The research team excluded 8‐matched pairs, leading to 800 included individuals.
The odds of any indication for clinical testing were similar among undiagnosed celiac disease and controls.
Most individual indications were not associated with serologic status.
Exceptions to this include hypothyroidism, which was more likely in cases of undiagnosed celiac disease, and dyspepsia and chronic diarrhea, which were less likely.
The team observed that cases of undiagnosed celiac disease were more likely to develop osteoporosis, dermatitis herpetiformis, chronic fatigue, thyroiditis, autoimmune diseases, and have a family member diagnosed with coeliac disease.
Dr Hujoel's team comments, "This study strongly suggests that current case finding is not effective in detecting undiagnosed celiac disease."
"Individuals with undiagnosed celiac disease were more likely than controls to develop indications for testing overtime."
"A more effective method for detection of celiac disease is needed."