S2257 Celiac Disease and Inflammatory Bowel Disease: Characteristics of a Dual Diagnosis
Notice bibliographique
Résumé
Introduction: A bidirectional association of celiac disease (CeD) and inflammatory bowel disease (IBD) has been well established. The existence of this dual diagnosis (CeD-IBD) poses questions regarding diagnosis, treatment, and potential synergistic effects on disease course. There remains a need for further understanding of the clinical implications of this dual diagnosis. Methods: A retrospective chart review of patients with CeD from The Mount Sinai Hospital was performed. In total, 354 patients carried a dual diagnosis of CeD-IBD. Any individual with serology and biopsy consistent with CeD and a concomitant diagnosis of IBD - either ulcerative colitis (UC) or Crohn’s Disease (CD) – confirmed by histology was included. Patients were excluded if data from initial diagnosis of either disease was missing. Results: Of the 1038 patients with CeD, a total of 38 (3.7%) carried a confirmed dual diagnosis – 53% were women and mean age of the cohort was 31.29. The most common presenting symptoms were abdominal pain and diarrhea. At initial visit, mean TTG IGA was 108 U/mL and the majority (68%) had Marsh 3 on biopsy. Mean age of diagnosis was oldest in the CeD-UC cohort. A higher proportion of CeD-IBD patients had CD (73.7%) compared to UC (26.3%). Interval time to second diagnosis of IBD and CeD was 4.1 years and 3.2 years respectively. 2 patients had a gastrointestinal infection preceding IBD diagnosis (mean interval of 16.5 days), both in the CD cohort. 71% of CeD-IBD patients required the use of biologics for treatment of IBD. 14.2% of CD patients had stricturing or penetrating disease and 40% of UC patients had extensive colonic involvement. Conclusion: CeD-IBD dual diagnosis creates complex pathophysiology yet to be fully understood. Further investigation with direct comparisons to CeD and IBD cohorts may be beneficial in order to better understand the interrelation of these diseases, outline potential disease course, and guide clinical management (see Table 1). Table 1. - Characteristics of Patients with a dual diagnosis of Celiac Disease and Inflammatory Bowel Disease CeD+IBD Number of Patients 38 UC 10 CD 28 CeD 38 Number of Males 18 (47.3) Number of Women 20 (52.6) Mean Age 31.29 Race (%) White 29 (76.3) Black 0 Asian/ Pacific Islander 1 (2.6) Hispanic 0 Other 9 (23.6) Mean BMI at Dx 21.88* Mean (Median) Age of CeD Dx 23.04 (18.4) Mean (Median) Age of CD Dx 20.32 (16.4) Mean (Median) Age of UC Dx 33.89 (28.9) Mean Time Between Dx, Years UC 1st, CeD 2nd 2 CD 1st, CeD 2nd 3.7 CeD 1st, UC 2nd 5.4 CeD 1st, CD 2nd 3 Family History Autoimmune 3 (7.9) Celiac 7 (18.4) IBD 5 (13.1) Symptoms at Presentation, n Diarrhea 20 Nausea 8 Vomiting 5 Abdominal Pain 24 Bloody Stools 11 Constipation 6 Weight Loss 12 Bloating 5 Extra-intestinal Symptoms 10 Unknown 1 No Symptoms 1 Montreal Classification, n E1 2 E2 3 E3 4 S0 0 S1 5 S2 2 S3 2 A1 16 A2 7 A3 2 L1 8 L2 6 L3 11 L4 2 B1 21 B2 2 B3 1 B4 1 p 2 Penetrating Disease (%) 14.2 Paninvolvement (%) 40 Mean TTG at time of Dx 108 Marsh Classification, n I 11 II 0 IIIa 12 IIIb 8 IIIc 6 Unknown 1 Marsh III Classification (%) 26 (68.4) Celiac Remission (%) 13 (34.2) Mean (Median) Time to Remission in Years 5 (5) History of Prior GI Infection, n 2 Mean (Median) Time between Infection and Dx in days 16.5 (16.5) UC 0 CD 33 History of T- Cell Lymphoma, n 0 CeD: Celiac Disease; UC: Ulcerative Colitis; CD: Crohn's Disease; IBD: Inflammatory Bowel Disease; GI: Gastrointestinal; BMI: Body Mass Index; Dx: Diagnosis; TTG: Tissue Transglutaminase; n: number.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,010 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».