Giovanni A Roldan1,2, Sehrish Jamot3, Krzysztof Kopec4, Amber Charoen5, Daniel Leffler2, Edward R Feller6, Samir A Shah7,8. 1. Internal Medicine Department, Jackson Memorial Hospital, University of Miami, Miami, FL, 33136, USA. 2. Celiac Center at Beth Israel Deaconess Medical Center, Boston, MA, 02115, USA. 3. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY, 14263, USA. 4. Connecticut GI, PC, Farmington, CT, 06032, USA. 5. Division of Gastroenterology, Department of Medicine, Warren Alpert School of Medicine, Brown University, Providence, RI, 02904, USA. 6. Division of Medical Education, Warren Alpert Medical School of Brown University, Providence, RI, 02912, USA. 7. Division of Gastroenterology, Department of Medicine, Warren Alpert School of Medicine, Brown University, Providence, RI, 02904, USA. samir@brown.edu. 8. Gastroenterology Associates, Inc., 44 West River Street, Providence, RI, 02904, USA. samir@brown.edu.
Abstract
BACKGROUND: The description of the clinical presentation of celiac disease (CeD) has usually come from studies at referral centers. Data about CeD presentation in the community are sparse. AIMS: We aim to describe the clinical presentation of patients with biopsy-proven CeD at a community-based adult gastroenterology practice and compare it to a referral center. METHODS: We performed a retrospective study of two cohorts of patients diagnosed with CeD between 2000-2007 (n = 117) and 2013-2016 (n = 91) in a community practice, and a third cohort (n = 188) diagnosed between 2000 and 2007 in a tertiary referral center. The clinical presentation, body mass index, tissue-transglutaminase levels, DEXA scan, vitamin D levels, and vaccine recommendations were assessed. RESULTS: Celiac disease presentation changed over time in the two community cohorts. Recently, fewer patients presented with diarrhea and anemia, but constipation and neurologic symptoms were more common. The most recent cohort had a higher proportion of patients who were overweight or obese than the first cohort. However, the body mass index in both community cohorts was higher than in the tertiary referral center. The frequency of osteopenia and osteoporosis was high in both community cohorts. The tertiary referral center patients were younger, presented with a higher proportion of diarrhea and a lower body mass index. CONCLUSIONS: The clinical presentation of CeD differs between the community setting and a tertiary referral center. Patients with CeD presenting to the community setting tended to be older, overweight, and to have a high proportion of mineral bone disease.
BACKGROUND: The description of the clinical presentation of celiac disease (CeD) has usually come from studies at referral centers. Data about CeD presentation in the community are sparse. AIMS: We aim to describe the clinical presentation of patients with biopsy-proven CeD at a community-based adult gastroenterology practice and compare it to a referral center. METHODS: We performed a retrospective study of two cohorts of patients diagnosed with CeD between 2000-2007 (n = 117) and 2013-2016 (n = 91) in a community practice, and a third cohort (n = 188) diagnosed between 2000 and 2007 in a tertiary referral center. The clinical presentation, body mass index, tissue-transglutaminase levels, DEXA scan, vitamin D levels, and vaccine recommendations were assessed. RESULTS: Celiac disease presentation changed over time in the two community cohorts. Recently, fewer patients presented with diarrhea and anemia, but constipation and neurologic symptoms were more common. The most recent cohort had a higher proportion of patients who were overweight or obese than the first cohort. However, the body mass index in both community cohorts was higher than in the tertiary referral center. The frequency of osteopenia and osteoporosis was high in both community cohorts. The tertiary referral center patients were younger, presented with a higher proportion of diarrhea and a lower body mass index. CONCLUSIONS: The clinical presentation of CeD differs between the community setting and a tertiary referral center. Patients with CeD presenting to the community setting tended to be older, overweight, and to have a high proportion of mineral bone disease.
Authors: Benjamin Lebwohl; Christina A Tennyson; Jennifer L Holub; David A Lieberman; Alfred I Neugut; Peter H R Green Journal: Gastrointest Endosc Date: 2012-06-23 Impact factor: 9.427
Authors: James A King; Jocelyn Jeong; Fox E Underwood; Joshua Quan; Nicola Panaccione; Joseph W Windsor; Stephanie Coward; Jennifer deBruyn; Paul E Ronksley; Abdel-Aziz Shaheen; Hude Quan; Jenny Godley; Sander Veldhuyzen van Zanten; Benjamin Lebwohl; Siew C Ng; Jonas F Ludvigsson; Gilaad G Kaplan Journal: Am J Gastroenterol Date: 2020-04 Impact factor: 10.864
Authors: Prashant Singh; Ananya Arora; Tor A Strand; Daniel A Leffler; Carlo Catassi; Peter H Green; Ciaran P Kelly; Vineet Ahuja; Govind K Makharia Journal: Clin Gastroenterol Hepatol Date: 2018-03-16 Impact factor: 11.382
Authors: Alberto Rubio-Tapia; Robert A Kyle; Edward L Kaplan; Dwight R Johnson; William Page; Frederick Erdtmann; Tricia L Brantner; W Ray Kim; Tara K Phelps; Brian D Lahr; Alan R Zinsmeister; L Joseph Melton; Joseph A Murray Journal: Gastroenterology Date: 2009-04-10 Impact factor: 22.682
Authors: Alberto Rubio-Tapia; Jonas F Ludvigsson; Tricia L Brantner; Joseph A Murray; James E Everhart Journal: Am J Gastroenterol Date: 2012-07-31 Impact factor: 10.864
Authors: Jonas F Ludvigsson; Alberto Rubio-Tapia; Carol T van Dyke; L Joseph Melton; Alan R Zinsmeister; Brian D Lahr; Joseph A Murray Journal: Am J Gastroenterol Date: 2013-03-19 Impact factor: 10.864