Clinical, Serologic, and Histologic Characteristics in Screen-Detected and Clinically Diagnosed Celiac Disease Patients

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Background and Aims: The benefits of celiac disease screening remain debatable. We compared baseline characteristics and treatment outcomes between screen-detected and clinically diagnosed celiac disease adults in a prospective study. Methods: Clinical, serologic, and histologic data and bone mineral density (BMD) were assessed in 214 patients at diagnosis and after 1 year on gluten-free diet (GFD). Validated questionnaires were used to elicit gastrointestinal symptoms (Gastrointestinal Symptoms Rating Scale) and quality of life (Psychological General Well-Being questionnaire). Asymptomatic and symptomatic screen-detected patients were comparable in histologic findings at diagnosis, adherence to GFD, and improvements in symptoms and quality of life. Conclusion: Screen-detected celiac disease patients demonstrated less severe symptoms and BMD impairment at diagnosis but advanced histologic and serologic disease similar to those identified on clinical grounds. Adherence to GFD and treatment response were comparable between the groups.