Jinga Mariana, Popp Alina, Balaban Daniel Vasile, Dima Alina, Jurcut Ciprian
Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; Dr Carol Davila Central Military Emergency University Hospital, Bucharest, Romania.
Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; Alessandrescu-Rusescu Institute for Mother and Child Health, Bucharest, Romania.
Turk J Gastroenterol. 2018 Jul;29(4):419-426. doi: 10.5152/tjg.2018.17236.
BACKGROUND/AIMS: Despite its high prevalence, affecting about 1% of the general population, celiac disease (CD) remains heavily underdiagnosed. Among the reasons for underdiagnosis, awareness among medical professionals has been little studied. The aim of this survey was to determine physicians' knowledge in regard to CD in adult patients.
An 18-items questionnaire pointing out general features, clinical presentation, diagnosis and management of CD patients was addressed to physicians from different medical specialties, in training or board-certified, from one universitary center.
Altogether 153 physicians were invited to complete the survey (69.3% female, 35.9% gastroenterologists). Overall, 69.9% of the physicians questioned considered CD as a rare disorder. Lymphoma increased risk was highlighted in significant higher proportion by gastroenterologists when compared with physicians of other medical specialty. Chronic diarrhea, weight loss, iron-deficiency anemia, and abdominal pain were the first four conditions recognized as associated with CD, by 94.1%, 76.5%, 61.4%, and 54.2% study participants, respectively. About one-third of respondents (34.5%) affirmed to perform total serum IgA testing in all patients tested for CD. Intestinal biopsy confirmation of a positive celiac serology was reported by 65.4% physicians, with a higher proportion among gastroenterologists: 81.5% versus 56.6%. In regard to CD management, both groups concluded that referral to specialized centers should be recommended.
This study highlights poor awareness among the physicians' in regard to important CD features and diagnostic recommendations in adult patients. More efforts are warranted to improve awareness on CD features among physicians of different medical specialties.
背景/目的：尽管乳糜泻（CD）发病率较高，约影响1%的普通人群，但仍存在大量漏诊情况。在漏诊原因中，医学专业人员对此病的认知情况鲜少被研究。本调查旨在确定医生对成年CD患者的了解程度。
向来自一所大学中心、处于培训阶段或已获得委员会认证的不同医学专业的医生发放一份包含18个条目的问卷，问卷内容涉及CD患者的一般特征、临床表现、诊断和管理。
共邀请153名医生完成调查（女性占69.3%，胃肠病学家占35.9%）。总体而言，69.9%的受访医生认为CD是一种罕见疾病。与其他医学专业的医生相比，胃肠病学家更倾向于强调淋巴瘤风险增加。慢性腹泻、体重减轻、缺铁性贫血和腹痛是被研究参与者分别认为与CD相关的前四种情况，分别占94.1%、76.5%、61.4%和54.2%。约三分之一的受访者（34.5%）确认在所有接受CD检测的患者中都进行了总血清IgA检测。65.4%的医生报告通过肠道活检证实了乳糜泻血清学检测呈阳性，胃肠病学家中的比例更高：81.5%对56.6%。关于CD的管理，两组都得出结论，应建议转诊至专科中心。
本研究凸显了医生对成年患者CD的重要特征和诊断建议的认知不足。有必要做出更多努力，以提高不同医学专业医生对CD特征的认识。
