[Celiac disease: diagnosis prevalence in a community hospital]

Celiac disease (CD) is a gluten-sensitive enteropathy characterized by a chronic injury of the small bowel, caused by gluten intolerance in genetically predisposed individuals. The different forms of presentation of CD resemble more a multisystem disorder than a primary gastrointestinal disease and it is frequently underdiagnosed.

To determine the prevalence of CD diagnosis in the population of affiliates to the HMO of the Hospital Italiano de Buenos Aires.

This is a cross sectional study, using secondary databases of diagnosis and laboratory from the electronic medical record (EMR) in a HMO population between 1998 and 2006. The criteria used to define a case was based on a diagnosis of CD in the EMR and/or a IgA antitransglutaminase antibodies value >15 AU/mL.

According to these criteria, 283 patients with CD were identified in 128,748 individuals of the HMO. The prevalence of CD was 0.22%. The mean age of this group was of 42.3 years, and 80.2% of them were female.

In a primary care HMO setting, using secondary databases from EMR we found 1 case of celiac disease every 470 affiliates, giving a prevalence of 0.22%. The rate between serological prevalence of CD and clinical diagnosis carried out in our center was near 3.3 to 1. Although this level of diagnosis could be considered relatively high, an important proportion of patients are left without diagnosis, considering the local estimated prevalence reported using serological tests. An increased level of awareness and clinical suspicion is needed at the primary care level.