Pinto Sánchez María Inés, Smecuol Edgardo, Vázquez Horacio, Mazure Roberto, Mauriño Eduardo, Bai Julio César
Small Bowel Section, Department of Medicine, "Dr Carlos Bonorino Udaondo" Gastroenterology Hospital, Ciudad Autónoma de Buenos Aires, Argentina.
Acta Gastroenterol Latinoam. 2009 Dec;39(4):250-3.
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.
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.
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.
Our study detected a high rate of histopathological and serological misdiagnosis of CD in community practice which may have profound negative impact on patients.
我们评估了在社区临床环境中对乳糜泻（CD）的诊断准确性，并与学术经验丰富的中心进行了比较。
对在社区环境中用于诊断的原始活检玻片和报告以及CD血清学进行了修订，这70例连续就诊于我们机构寻求二次诊断意见的患者。一个专家团队在不知道原始诊断的情况下确定最终诊断。
样本质量差使得专家病理学家对8.7%的外部诊断为CD的玻片进行组织学评估时存在不确定性。在46.3%的可用病例中，我们发现两种实践环境之间存在不同诊断，社区中对CD的过度诊断明显（p < 0.0001）。72.2%的病例血清学结果一致。
我们的研究发现社区实践中CD的组织病理学和血清学误诊率很高，这可能对患者产生深远的负面影响。
