{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T15:10:13Z","timestamp":1790089813312,"version":"4.0.1"},"reference-count":34,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,11,14]],"date-time":"2023-11-14T00:00:00Z","timestamp":1699920000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Celiac disease (CeD) has now become a global disease with a worldwide prevalence of 0.67%. Despite being a common disease, CeD is often not diagnosed and there is a significant delay in its diagnosis. We reviewed the impact of the delay in the diagnosis on the severity of manifestations of CeD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We reviewed clinical records of 726 consecutive patients with CeD from the Celiac Clinic database and the National Celiac Disease Consortium database. We extracted specific data including the demographics, symptoms at presentation, time of onset of symptoms, time to diagnosis from the onset of the symptoms, and relevant clinical data including fold\u2010rise in anti\u2010tissue transglutaminase antibody (IgA anti\u2010tTG Ab) and severity of villous and crypt abnormalities as assessed using modified Marsh classification.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median duration between the onset of symptoms and the diagnosis of CeD was 27\u00a0months (interquartile range 12\u201360\u00a0months). A longer delay in the diagnosis of CeD from the onset of symptoms was associated with lower height for age, lower hemoglobin, higher fold rise in IgA Anti tTG titers, and higher severity of villous and crypt abnormalities. About 18% of patients presented with predominantly non\u2010gastrointestinal complaints and had a longer delay in the diagnosis of CeD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There is a significant delay in the diagnosis of CeD since the onset of its symptoms. The severity of celiac disease increases with increasing delay in its diagnosis. There is a need to keep a low threshold for the diagnosis of CeD in appropriate clinical settings.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.16385","type":"journal-article","created":{"date-parts":[[2023,11,14]],"date-time":"2023-11-14T23:28:47Z","timestamp":1700004527000},"page":"256-263","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Impact of delay in the diagnosis on the severity of celiac disease"],"prefix":"10.1111","volume":"39","author":[{"given":"Shubham","family":"Mehta","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Human Nutrition Unit All India Institute of Medical Sciences  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ankit","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Human Nutrition Unit All India Institute of Medical Sciences  New Delhi 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