S1422 A Concomitant Celiac Disease Diagnosis Does Not Worsen Clinical Outcomes of Inflammatory Bowel Disease
Notice bibliographique
Résumé
Introduction: Inflammatory bowel disease (IBD), Crohn’s disease (CD) and ulcerative colitis (UC), and celiac disease (CeD) are all characterized by inflammation of the gastrointestinal tract. A small subset of IBD patients is also diagnosed with CeD, though it is unclear what impact having a secondary diagnosis of CeD will have on a patient’s IBD presentation and disease course. The aim of this study is to determine the distinct and shared characteristics and clinical features of patients with UC, CD, and a dual diagnosis of CeD-UC or CeD-CD. Methods: A retrospective chart review of patients with UC, CD, and CeD-IBD from The Mount Sinai Hospital was performed. Charts were reviewed to ensure a 1:1:1 ratio of patients in each group. Inclusion criteria included any individual with UC or CD confirmed by histology and CeD patients confirmed by serology and biopsy with a concomitant diagnosis of IBD confirmed by histology. Patients were excluded if data from the initial diagnosis was missing. Results: A total of 38 CeD-IBD patients (53% female), 38 UC patients (55% female), and 38 CD patients (50% female) were evaluated. A higher proportion of CeD-IBD patients had CD (73.7%) compared to UC (26.3%). Mean age was highest in CD patients at 36.7. Mean age at diagnosis was highest in CeD-UC patients (33.9 years) compared to CeD-CD (20.3 years), UC (27.7 years) and CD (24.7 years). Family history of Celiac disease was significantly higher in patients with a dual diagnosis. Diarrhea, abdominal pain, extra intestinal symptoms, and bloody stools were the most common presenting symptoms in all cohorts. Patients with UC and CD has statistically higher rates of bloody stools compared to CeD-IBD patients. Need for biologic therapy was similar between UC (68.4%), CD (71.0%) and CeD-IBD (71.0%). The percentage of patients with stricturing or penetrating disease was significantly higher in CD (55.2%) than CeD-IBD (14.2%). Extensive UC involvement of the colon was higher in the UC cohort (65%) compared to the CeD-IBD cohort (40%). Conclusion: The concomitant diagnosis of CeD with IBD does not worsen the severity of either UC or CD. At a tertiary IBD referral center, CeD does not increase the rates of stricturing or penetrating CD and does not increase extent of colonic involvement in UC. Similar rates of biologic use among groups suggest a comparable IBD disease course between all cohorts (see Table 1). Table 1. - Characteristics of Patients with Inflammatory Bowel Disease, Ulcerative Colitis or Crohns, and Dual Disease of Inflammatory Bowel Disease and Celiac Disease UC Crohns CeD+IBD P-value Number of Patients 38 38 38 UC 10 (26.3) CD 28 (73.7) CeD 38 Number of Males (%) 19 (50.0) 17 (44.7) 18 (47.2) 0.89 Number of Females (%) 19 (50.0) 21 (55.2) 20 (52.6) Mean Age 35.9 36.7 31.3 0.23 Race (%) 0.61 White 27 (70.1) 23 (60.5) 29 (76.3) Black 1 (2.6) 2 (5.3) 0 Asian/Pacific Islander 1 (2.6) 0 1 (2.6) Hispanic 0 1 (2.6) 0 Other 9 (23.7) 12 (31.5) 9 (23.6) Mean BMI at Dx 23.19 22.57 21.88* 0.47 Mean Age (Median) at Dx 27.67 (26.0) 24.71 (21.8) UC 33.89 (28.9) 0.28 CD 20.33 (16.4) 0.19 CeD 23.04 (18.4) Family History (%) Autoimmune 3 (7.9) 2 (5.3) 3 (7.9) 0.01 Celiac 0 (0) 1 (2.6) 7 (18.4) 0.45 IBD 6 (15.7) 12 (31.5) 5 (13.1) 0.01 Symptoms at Presentation, n 0.13 Diarrhea 29 23 20 0.72 Nausea 5 8 8 0.53 Vomiting 3 8 5 0.29 Abdominal Pain 23 33 24 0.35 Bloody Stools 27 12 11 0.03 Constipation 8 1 6 0.08 Weight Loss 7 13 12 0.24 Bloating 6 3 5 0.58 Extra-Intestinal Symptoms 16 19 10 0.40 Unknown 0 0 1 0.31 No Symptoms 1 1 1 0.99 History of Prior GI infection 4 0 2 .12 Mean (Median) Time Between Infection and Dx in Days 43 (43) 16 (16.5) < 0 .001 UC 0 CD 33 Biologic Use (%) 26 (68.4) 27 (71.0) 27 (71.0) 0.96 Montreal Classification, n E1 0 2 0.01 E2 13 3 E3 25 4 S0 0 0 S1 19 5 0.91 S2 11 2 S3 8 2 A1 12 16 0 .04 A2 21 7 A3 5 2 L1 15 8 0.57 L2 4 6 L3 19 11 L4 4 2 B1 27 21 0.57 B2 5 2 B3 6 1 B4 0 1 p 10 2 0.16 Penetrating Disease (%) 55.2 14.2 0.018 Paninvolvement (%) 65.0 40.0 0.43 History of T- Cell Lymphoma 0 0 0 CeD: Celiac Disease; UC: Ulcerative Colitis; CD: Crohn's Disease; IBD: Inflammatory Bowel Disease; GI: Gastrointestinal; BMI: Body Mass Index; Dx: Diagnosis; n: number * BMI at first diagnosis of CD, CeD, or UC.
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 | 0,001 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,009 | 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 ».