Intest Res.  2018 Apr;16(2):288-292. 10.5217/ir.2018.16.2.288.

A simple phenotypic classification for celiac disease

• Sood A
• Midha V
• Makharia G
• Thelma BK
• Halli SS
• Mehta V
• Mahajan R
• Narang V
• Sood K
• Kaur K

• KMID: 2417681
• DOI: http://doi.org/10.5217/ir.2018.16.2.288

Abstract

BACKGROUND/AIMS
Celiac disease is a global health problem. The presentation of celiac disease has unfolded over years and it is now known that it can manifest at different ages, has varied presentations, and is prone to develop complications, if not managed properly. Although the Oslo definitions provide consensus on the various terminologies used in literature, there is no phenotypic classification providing a composite diagnosis for the disease.
METHODS
Various variables identified for phenotypic classification included age at diagnosis, age at onset of symptoms, clinical presentation, family history and complications. These were applied to the existing registry of 1,664 patients at Dayanand Medical College and Hospital, Ludhiana, India. In addition, age was evaluated as below 15 and below 18 years. Cross tabulations were used for the verification of the classification using the existing data. Expert opinion was sought from both international and national experts of varying fields.
RESULTS
After empirical verification, age at diagnosis was considered appropriate in between A1 ( < 18) and A2 (≥18). The disease presentation has been classified into 3 types-P1 (classical), P2 (non-classical) and P3 (asymptomatic). Complications were considered as absent (C0) or present (C1). A single phenotypic classification based on these 3 characteristics, namely age at the diagnosis, clinical presentation, and intestinal complications (APC classification) was derived.
CONCLUSIONS
APC classification (age at diagnosis, presentation, complications) is a simple disease explanatory classification for patients with celiac disease aimed at providing a composite diagnosis.

Keyword

Celiac disease; Classification; Presentation; Complications

MeSH Terms

Age of Onset
Celiac Disease*
Classification*
Consensus
Diagnosis
Expert Testimony
Global Health
Humans
India

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