S2257 Celiac Disease and Inflammatory Bowel Disease: Characteristics of a Dual Diagnosis
Bibliographic record
Abstract
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.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.010 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".