Diagnostic delay in children with coeliac disease: a national multicentre study in Turkey

There are few studies conducted investigating diagnostic delay in children with coeliac disease (CD). A better understanding of the factors associated with diagnostic delay and the development of strategies to reduce it are important in preventing long-term complications related to the disease. This study aimed to determine the median diagnostic delay in children with CD and to investigate possible underlying factors associated with diagnostic delay. A prospective screening program was performed in children with CD at the seven clinical centers operating in Turkey within the Focus IN CD project between June 2021 and June 2023. Paediatric gastroenterologists were asked to complete a web-based questionnaire about CD. The median age of the 188 children with CD (66 male; 35%) was 8.33 years (IQR: 5.02-13.00). The median diagnostic delay was 7.30 months (IQR: 2.73–15.50). Among the 188 patients included in the study, 172 (91.5%) were diagnosed within the first three years, whereas 16 (8.5%) were diagnosed after three years, and 68.7% of these patients had classical CD symptoms. Patients with CD were categorised according to the OSLO criteria. The median delay for the classic CD group, the nonclassic CD group and the silent CD group were found to be 7.63 (IQR: 3.13–16.06), 4.40 (IQR: 1.76–13.20) and 2.21 (IQR: 1.03–16.14) months, respectively. There were no significant differences between the patients with the classic CD group, and the nonclassic CD group, and the silent CD group (p = 0.564). The study revealed that the median diagnostic delay was 7.30 months. Furthermore there were no significant differences between clinical subtypes of CD. In order to minimize the delay in diagnosis, it may be a solution to raise community-based awareness of CD, and better inform pediatricians, and family physicians about CD.