{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T22:17:15Z","timestamp":1770416235984,"version":"3.49.0"},"reference-count":25,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2018,3,25]],"date-time":"2018-03-25T00:00:00Z","timestamp":1521936000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["RO1\u2010DK57892"],"award-info":[{"award-number":["RO1\u2010DK57892"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Coeliac disease is a substantially underdiagnosed disorder, with clinical testing currently guided by case finding.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To determine the presence of indications for diagnostic testing and frequency of clinical testing in undiagnosed coeliac disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a case\u2010control study of adults without prior diagnosis of coeliac disease. Undiagnosed cases were identified through sequential serology, and unaffected age\u2010 and gender\u2010matched controls were selected. Medical records were systematically reviewed for indications for and evidence of clinical testing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 47\u00a0557 adults, 408 cases of undiagnosed coeliac disease were identified. 408 serology negative matched controls were selected. Eight\u2010matched pairs were excluded, leading to 800 included individuals (61% female; median age 44.2\u00a0years). The odds of any indication for clinical testing were similar among undiagnosed coeliac disease and controls (odds ratio (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>) 1.18; 95% CI: 0.85\u20101.63, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.32). Most individual indications were not associated with serologic status. Exceptions to this include hypothyroidism, which was more likely in cases of undiagnosed coeliac disease, and dyspepsia and chronic diarrhoea, which were less likely. Cases of undiagnosed coeliac disease were more likely to develop osteoporosis (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.005), dermatitis herpetiformis (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.006), chronic fatigue (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.033), thyroiditis (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.003), autoimmune diseases (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.008), and have a family member diagnosed with coeliac disease (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study strongly suggests that current case finding is not effective in detecting undiagnosed coeliac disease. Individuals with undiagnosed coeliac disease were more likely than controls to develop indications for testing overtime. A more effective method for detection of coeliac disease is needed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.14625","type":"journal-article","created":{"date-parts":[[2018,3,26]],"date-time":"2018-03-26T06:55:50Z","timestamp":1522047350000},"page":"1358-1366","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":69,"title":["Natural history and clinical detection of undiagnosed coeliac disease in a North American community"],"prefix":"10.1111","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4065-539X","authenticated-orcid":false,"given":"I. A.","family":"Hujoel","sequence":"first","affiliation":[{"name":"Division of Internal Medicine Mayo Clinic Rochester MN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. T.","family":"Van Dyke","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Mayo Clinic Rochester MN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"Brantner","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Mayo Clinic Rochester MN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Larson","sequence":"additional","affiliation":[{"name":"Division of Biomedical Statistics and Informatics Mayo Clinic Rochester MN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K. S.","family":"King","sequence":"additional","affiliation":[{"name":"Division of Biomedical Statistics and Informatics Mayo Clinic Rochester MN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0700-2909","authenticated-orcid":false,"given":"A.","family":"Sharma","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Mayo Clinic Rochester MN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1941-9090","authenticated-orcid":false,"given":"J. A.","family":"Murray","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Mayo Clinic Rochester MN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Rubio\u2010Tapia","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Mayo Clinic Rochester MN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,3,25]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2005.02.014"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2009.03.059"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/jcgh.2003.50004"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2007.03502.x"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2012.219"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2013.79"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/1756283X11417038"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2007.01173.x"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012-3765"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.549"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2011.21"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2010.04.007"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.1462"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.1105"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2010.05.041"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2013-306578"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0b013e31827a6f83"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2015.01.044"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.giec.2012.07.004"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.163.3.286"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.15.1331"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/amiajnl-2013-001924"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2007.01360.x"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2016.5254"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2012.02.029"}],"container-title":["Alimentary Pharmacology &amp; Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fapt.14625","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apt.14625","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,17]],"date-time":"2023-09-17T09:25:12Z","timestamp":1694942712000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apt.14625"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,3,25]]},"references-count":25,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2018,5]]}},"alternative-id":["10.1111\/apt.14625"],"URL":"https:\/\/doi.org\/10.1111\/apt.14625","archive":["Portico"],"relation":{},"ISSN":["0269-2813","1365-2036"],"issn-type":[{"value":"0269-2813","type":"print"},{"value":"1365-2036","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,3,25]]},"assertion":[{"value":"2017-12-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-03-02","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-03-25","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}