Original articleEtiologies and Predictors of Diagnosis in Nonresponsive Celiac Disease
Section snippets
Methods
A database of all patients seen at our institution from January 1, 2000, to April 1, 2006, coded for CD under the International Classification of Diseases 9th edition code 579.0 was compiled and predetermined clinical data were recorded. From this list, 603 patients were found to have biopsy examination–proven CD. Individuals without definitive evidence of CD in the form of duodenal biopsy examination, or skin biopsy examination in cases of dermatitis herpetiformis, were not included in this
Results
A total of 113 of 603 (18.7%) individuals with CD were found to have NRCD. Of the 113 patients, 74 (65%) were referred by clinicians from outside our institution and the remaining 39 (35%) patients were cared for at our institution from the initial diagnosis of CD onward. NRCD accounted for 35% of the 211 new referrals to our celiac center. The majority of the remaining referrals were for either confirmation of diagnosis or general management of previously diagnosed CD. Thirty-nine of the 392
Discussion
In this study we report the incidence, etiology, and clinical characteristics of 113 consecutive NRCD patients seen at our center over the preceding 5 years. Our findings are consistent with those of other reports; however, the larger size of our patient population allows for increased statistical power and for us to make diagnostic predictions based on presenting symptoms. As in past studies,8 gluten exposure remains the most common cause of NRCD and is the only diagnostic category
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Supported by a National Institutes of Health T32 research grant.