Low Yield for Routine Laboratory Checks in Follow-up of Coeliac Disease
Open accessAbstract
Aim: To evaluate the yield of routine laboratory tests and Dual Energy X-ray Absorptiometry (DEXA) scans in coeliac disease. Methods: A retrospective analysis of medical files of all followed-up patients with coeliac disease attending Rijnstate Hospital in 2016 was conducted with respect to blood tests of hemoglobin, vitamin B12, folate acid, iron status, calcium, vitamin D, glucose, thyroid function, DEXA-scans and related symptoms or signs of abnormalities. All patients had positive coeliac serology and/or biopsy-proven coeliac disease and attended regular visits after diagnosis. The chi-square test for trend was used for statistical analysis: a two-tailed probability of p < 0.05 was considered significant. Results: We analyzed 250 patients with a median follow-up of 7.8 (1-22) years. At diagnosis, we found anemia in 24.4%, iron deficiency in 38%, folic acid deficiency in 22.6% and vitamin B12 deficiency in 15.9%. All deficiencies recovered within 1-2 years with or without supplements. Deficiencies or autoimmune diseases occurred in 50 patients (37 possibly coeliac-related) during follow-up. Twelve cases of coeliac-related deficiencies or autoimmune diseases occurred in patients with normal values at diagnosis of whom 10 were asymptomatic (incidence 10/1000 patient years). Osteoporosis and osteopenia were present in 23.3% and 35% at diagnosis. In most patients bone mineral density (BMD) improved or stabilized during follow up (p < 0.05), 8% deteriorated. Conclusions: The incidence of asymptomatic coeliac-related deficiencies or autoimmune diseases is low in patients with normal values at diagnosis. Therefore, routine laboratory screening is not necessary in this group: attending regular follow-up visits should be sufficient. DEXA scans are recommended.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Anaemia is a frequent finding (12-24%) in children with untreated celiac disease.
“Anaemia is a frequent finding (12-24%) in children with untreated CD (64, 67-70).”
From ESPGHAN Position Paper on Management and Follow-up of Children and Adolescents With Celiac Disease. (2022) · cites this paper as [67]
The Abstract (p. 2) reports anaemia in 24.4% of patients at coeliac disease diagnosis, supporting the claim that anaemia is frequent at diagnosis. It does not report a 12–24% range for children specifically; the Methods (p. 3) indicate that the cohort included patients diagnosed during childhood but do not give a childhood-specific anaemia rate. (LLM, conf=0.88)
Experimental — accuracy not yet measuredIn most cases (84%-96%) anaemia improves or recovers on a gluten-free diet.
“In most cases (84%-96%) anaemia improves or recovers on a GFD (14, 64, 67, 70, 72).”
From ESPGHAN Position Paper on Management and Follow-up of Children and Adolescents With Celiac Disease. (2022) · cites this paper as [67]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
The publisher hasn’t deposited this paper’s reference list.
Research works printed but not linked: 13
- [2]2. Murray JA. The widening spectrum of celiac disease. Am J Clin Nutr 1999;69:354-365.
- [7]7. Nieuwenhuis WP, Kneepkens CM, Houwen RH, de Beer HJ, Mulder CJ, Mearin ML. Guideline ,Coeliac disease and dermatitis herpetiformis' . Ned Tijdschr Geneeskd 2010;154:A1904.
- [9]9. Diamanti A, Capriati T, Bizzarri C, et al. Autoimmune diseases and celiac disease which came first: genotype or gluten? Expert Rev Clin Immunol 2016;12:67-77. doi:10.1586/1744666X.2016.1095091 · DOI
- [11]11. Bergamaschi G, Markopoulos K, Albertini R, et al. Anemia of chronic disease and defective erythropoietin production in patients with celiac disease. Haematologica 2008;93:1785-1791. doi:10.3324/ haematol.13255
- [18]18. Schosler L, Christensen LA, Hvas CL. Symptoms and findings in adult-onset celiac disease in a historical Danish patient cohort. Scand J Gastroenterol 2016;51:288-294 doi:10.3109/00365521.2015.1092576 · DOI
- [20]20. Clarke R, Grimley Evans J, Schneede J, et al. Vitamin B12 and folate deficiency in later life. Age Ageing 2004;33:34-41. doi:10.1093/ageing/ afg109 · DOI
- [22]22. Loikas S, Koskinen P , Irjala K, et al. Vitamin B12 deficiency in the aged: a population-based study. Age Ageing 2007;36:177-183. doi:10.1093/ ageing/afl150
- [24]24. Martinsson A, Andersson C, Andell P, Koul S, Engstrom G, Smith JG. Anemia in the general population: prevalence, clinical correlates and prognostic impact. Eur J Epidemiol 2014;29:489-498. doi:10.1007/ s10654-014-9929-9
- [25]25. de Benoist B, McLean E, Egli I, Cogswell M. (Eds.). Worldwide prevalence of anaemia 1993-2005: WHO global database on anaemia. World Health Organization. Geneva 2008. Available at: http://www. who.int/iris/handle/10665/43894
- [27]27. Hakanen M, Luotola K, Salmi J, Laippala P, Kaukinen K, Collin P. Clinical and subclinical autoimmune thyroid disease in adult celiac disease. Dig Dis Sci 2001;46:2631-2635. doi:10.1023/A:1012754824553 · DOI
- [29]29. Ventura A, Neri E, Ughi C, Leopaldi A, Citta A, Not T. Glutendependent diabetes-related and thyroid-related autoantibodies in patients with celiac disease. J Pediatr 2000;137:263-265. doi:10.1067/ mpd.2000.107160
- [31]31. Pantaleoni S, Luchino M, Adriani A, et al. Bone mineral density at diagnosis of celiac disease and after 1 year of gluten-free diet. ScientificWorldJournal 2014;2014:173082. doi:10.1155/2014/173082 · DOI
- [32]32. Ukkola A, Kurppa K, Collin P, et al. Use of health care services and pharmaceutical agents in coeliac disease: a prospective nationwide study. BMC Gastroenterol 2012;12:136. doi:10.1186/1471-230X-12-136 · DOI
Cited by
Sorted by citations
ESPGHAN Position Paper on Management and Follow-up of Children and Adolescents With Celiac Disease.
Mearin, M. L., Agardh, D., Antunes, H., Al‐toma, A., Auricchio, R., Castillejo, G., Catassi, C., Ciacci, C., Discepolo, V., Dolinsek, J., et al. (2022) · Journal of pediatric gastroenterology and nutrition · doi:10.1097/mpg.0000000000003540 · Cited by 186 · see citing works
Self-citationGuidelines for best practices in monitoring established coeliac disease in adult patients
Elli, L., Leffler, D. A., Cellier, C., Lebwohl, B., Ciacci, C., Schümann, M., Lundin, K. E. A., Zammit, S. C., Sidhu, R., Roncoroni, L., et al. (2023) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/s41575-023-00872-2 · Cited by 109 · see citing works
Görög, A., Antiga, E., Caproni, M., Cianchini, G., De, D., Dmochowski, M., Dolinšek, J., Drenovska, K., Feliciani, C., Hervonen, K., et al. (2021) · Journal of the European Academy of Dermatology and Venereology · doi:10.1111/jdv.17183 · Cited by 59 · see citing works
Felber, J., Schümann, M., Bläker, H., Fischbach, W., Koletzko, S., Laass, M. W., Lachmann, N., Lorenz, P., Lynen, P., Reese, I., et al. (2022) · Zeitschrift für Gastroenterologie · doi:10.1055/a-1741-5946 · Cited by 54 · see citing works
Kurppa, K., Mulder, C. J. J., Størdal, K., & Kaukinen, K. (2024) · Gastroenterology · doi:10.1053/j.gastro.2023.12.026 · Cited by 30 · see citing works
Clinical Data Do Not Reliably Predict Duodenal Histology at Follow-up in Celiac Disease
Patel, N. J., Leffler, D. A., Al-Toma, A. A., Mulder, C. J. J., Elli, L., Gan, G., Patil, P., Atsawarungruangkit, A., Kuijpers, K. C., GOBBO, A. D., et al. (2023) · The American Journal of Surgical Pathology · doi:10.1097/pas.0000000000002150 · Cited by 21 · see citing works
Santonicola, A., Wieser, H., Gizzi, C., Soldaini, C., & Ciacci, C. (2024) · Nutrients · doi:10.3390/nu16121814 · Cited by 22 · see citing works
Cyrkot, S., Anders, S., Kamprath, C., Liu, A., Mileski, H., Dowhaniuk, J., Nasser, R., Marcon, M., Brill, H., Turner, J. M., et al. (2020) · International Journal of Food Sciences and Nutrition · doi:10.1080/09637486.2020.1734545 · Cited by 17 · see citing works
Al-Toma, A. A., Branchi, F., Zingone, F., Schiepatti, A., Malamut, G., Canova, C., Rosato, I., Ocagli, H., Trott, N., Elli, L., et al. (2026) · United European Gastroenterology Journal · doi:10.1002/ueg2.70195 · Cited by 14 · see citing works
Sayar, S., Aykut, H., Kaya, Ö., Kürbüz, K., Ak, Ç., Gökçen, P., Bilgiç, N. M., Adalı, G., Kahraman, R., Doğanay, H. L., et al. (2021) · The Turkish Journal of Gastroenterology · doi:10.5152/tjg.2021.20313 · Cited by 13 · see citing works
Certain Aspects of Nutritional Security of People with Gluten-Related Disorders
Siminiuc, R., & Țurcanu, D. (2020) · Food and Nutrition Sciences · doi:10.4236/fns.2020.1111072 · Cited by 11 · see citing works
Ben‐Ami, T., Trotskovsky, A., Topf‐Olivestone, C., & Kori, M. (2024) · European Journal of Pediatrics · doi:10.1007/s00431-024-05721-1 · Cited by 8 · see citing works
Management of coeliac disease patients after the confirmation of diagnosis in Central Europe
Riznik, P., Leo, L. D., Dolinsek, J., Gyimesi, J., Klemenak, M., Koletzko, B., Koletzko, S., Koltai, T., Korponay-Szabó, I. R., Krencnik, T., et al. (2021) · European Journal of Gastroenterology & Hepatology · doi:10.1097/meg.0000000000002039 · Cited by 7 · see citing works
Patel, N. J., & Robert, M. E. (2020) · The American Journal of Surgical Pathology · doi:10.1097/pas.0000000000001639 · Cited by 9 · see citing works
Long‐term laboratory follow‐up is essential in pediatric patients with celiac
Krauthammer, A., Guz‐Mark, A., Zevit, N., Waisbourd‐Zinman, O., Mozer‐Glassberg, Y., Friedler, V. N., Lev, M. R. B., Matar, M., Shouval, D. S., & Shamir, R. (2025) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1002/jpn3.70004 · Cited by 4 · see citing works
Düztaş, D. T., Tülüce, M. E., & Uyar, G. Ö. (2026) · Children · doi:10.3390/children13040547 · Cited by 1 · see citing works
Kurppa, K., & Agardh, D. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-821571-5.00002-7 · Cited by 1 · see citing works
Patel, P., & Micić, D. (2022) · Springer eBooks · doi:10.1007/978-3-030-94953-2_6
- Authors
- Burger, J. P., Van der Laan, J. J., Jansen, T. A., Drenth, J. P., Roovers, E. A., Wessels, M. M., & Wahab, P. J.
- Affiliations
- Rijnstate Hospital (NL)
- Radboud University Medical Center (NL)
- Venue
- Journal of Gastrointestinal and Liver Diseases
- Published
- 2018-09-30
- Volume
- 27
- Issue
- 3
- Pages
- 233-239
- ISSN
- 1221-4167 (ISSN-L)
- 1842-1121
- 1841-8724
- OpenAlex
- W4236111975
- Cited by
- 19
- References
- 0
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 3 · 2023: 2 · 2022: 4 · 2021: 4 · 2020: 3
- FWCI
- 1.69
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- Journal of Gastrointestinal and Liver Diseases (publishedVersion)
- PubMed (publishedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Celiac Disease Research and Management
- Health Sciences › Medicine › Surgery › Eosinophilic Esophagitis
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Keywords
- celiac disease, screening yield, iron deficiency, folate deficiency, vitamin B12 deficiency, anemia, autoimmune disease, osteoporosis, osteopenia, bone mineral density, follow-up visits
- MeSH terms
- Autoimmune Diseases, Blood Chemical Analysis, Bone Diseases, Metabolic, Celiac Disease, Deficiency Diseases, Humans, Netherlands, Osteoporosis, Predictive Value of Tests, Prognosis, Retrospective Studies, Risk Factors, Time Factors, Biomarkers, Absorptiometry, Photon, Incidence, Diet, Gluten-Free
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
