Coeliac disease is common yet often undiagnosed because symptoms may be trivial, nonspecific, or non-gastrointestinal, or because of lack of clinician awareness.
Serum IgA-class endomysial antibodies (EmA) have high specificity for coeliac disease and may facilitate case-finding by clinicians other than gastroenterologists.
We assessed the appropriateness and diagnostic yield of of requests for EmA by primary care general practitioners in a defined geographic area of Northern Ireland.
We identified patients who had EmA examination requests by their general practitioners during 1994-1996.
Individual patient questionnaires were posted to the general practitioners concerned, seeking information on indications for testing, management after the result, and final diagnosis.
We compared new patient diagnosis rates in two catchment areas, one served by a large district general hospital with, and the other by smaller hospitals without, a medical gastroenterology facility.
A total of 239 patients had coeliac profile testing by 69 of 177 general practitioners in the area.
Data were available for 181 patients not previously known to have coeliac disease, of whom 20 (11%) had EmA.
All EmA-positive patients were referred to hospital, where 19 underwent small-bowel biopsy, which confirmed coeliac disease in all 19. (...)
Mots-clés Pascal : Coeliaque maladie, Diagnostic, Soin santé primaire, Prescription médicale, Sérologie, Anticorps, Spécificité, Indication, Evaluation performance, Homme, Appareil digestif pathologie, Intestin pathologie, Malabsorption intestinale, Immunopathologie, Endomysium
Mots-clés Pascal anglais : Coeliac disease, Diagnosis, Primary health care, Medical prescription, Serology, Antibody, Specificity, Indication, Performance evaluation, Human, Digestive diseases, Intestinal disease, Intestinal malabsorption, Immunopathology, Endomysium
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0286069
Code Inist : 002B13B03. Création : 27/11/1998.