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Diagnostic Delay of Celiac Disease in Childhood

Diagnostic Delay of Celiac Disease in Childhood

April 9, 2024 | Paola Ilaria Bianchi, MD; Marco Vincenzo Lenti, MD; Clarissa Petrucci, MD; Giulia Gambini, MD; Nicola Aronica, MD; Matteo Varallo, MD; Carlo Maria Rossi, MD; Elena Pozzi, MD; Elena Groppali, MD; Francesca Siccardo, MD; Giulia Franchino, MD; Gian Vincenzo Zuccotti, MD; Grazia Di Leo, MD; Chiara Zanchi, MD; Fernanda Cristofori, MD; Ruggiero Franchavilla, MD; Marina Aloi, MD; Giulia Gagliostro, MD; Monica Montuori, MD; Sara Romaggioli, MD; Caterina Strisciuglio, MD; Marco Crocco, MD; Noemi Zampatti, MD; Angela Calvi, MD; Renata Auricchio, MD; Costantino De Giacomo, MD; Silvia Maria Elena Caimmi, MD; Carolina Carraro, MD; Annamaria Staiano, MD; Sabrina Cenni, MD; Mauro Congia, MD; Enrico Schirru, BSc; Francesca Ferretti, MD; Carolina Giacci, MD; Nicoletta Vecchione, MD; Mario Andrea Latorre, MD; Semela Resuli, MD; Giusy Cinzia Moltisanti, MD; Giulia Maria Abruzzese, MD; Andrea Quadrelli, MD; Simone Saglio, MD; Pietro Canu, MD; Damiano Ruggeri, MD; Annalisa De Silvestri, MD; Catherine Klersy, MD; Gian Luigi Marseglia, MD; Gino Roberto Corazza, MD; Antonio Di Sabatino, MD
This study investigates the diagnostic delay of pediatric celiac disease (CD) in Italy, focusing on factors associated with this delay. A retrospective, cross-sectional study was conducted among 3171 pediatric patients (aged 0-18 years) diagnosed with CD from 13 tertiary referral centers between 2010 and 2019. The median overall diagnostic delay was 5 months, with preconsultation and postconsultation delays of 2 and 1 months, respectively. Extreme diagnostic delays (1.5 × 75th percentile) occurred in 18.5% of cases, with median delays of 11 months. Factors associated with shorter diagnostic delays included younger age at diagnosis (younger than 3 years) and male gender. Family history of CD was linked to lower preconsultation and overall extreme diagnostic delays. Neurological symptoms, gastroesophageal reflux, and failure to thrive were associated with more frequent extreme diagnostic delays. Misdiagnosis before the definitive diagnosis of CD was reported in 4.0% of cases, with gastroesophageal reflux being the most common misdiagnosis. The study suggests that while the diagnostic delay for CD in children is generally low, certain clinical features can influence the timing of diagnosis.This study investigates the diagnostic delay of pediatric celiac disease (CD) in Italy, focusing on factors associated with this delay. A retrospective, cross-sectional study was conducted among 3171 pediatric patients (aged 0-18 years) diagnosed with CD from 13 tertiary referral centers between 2010 and 2019. The median overall diagnostic delay was 5 months, with preconsultation and postconsultation delays of 2 and 1 months, respectively. Extreme diagnostic delays (1.5 × 75th percentile) occurred in 18.5% of cases, with median delays of 11 months. Factors associated with shorter diagnostic delays included younger age at diagnosis (younger than 3 years) and male gender. Family history of CD was linked to lower preconsultation and overall extreme diagnostic delays. Neurological symptoms, gastroesophageal reflux, and failure to thrive were associated with more frequent extreme diagnostic delays. Misdiagnosis before the definitive diagnosis of CD was reported in 4.0% of cases, with gastroesophageal reflux being the most common misdiagnosis. The study suggests that while the diagnostic delay for CD in children is generally low, certain clinical features can influence the timing of diagnosis.
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[slides and audio] Diagnostic Delay of Celiac Disease in Childhood