The diagnosis of celiac disease may be delayed under a number of circumstances.
Reasons for a delay in diagnosis of celiac disease:
(1) silent or extraintestinal manifestations only, with no gastrointestinal symptoms
(2) onset of symptoms in the older adult
(3) false negative work-up
(4) failure to consider the diagnosis
(5) mixed disorder with the presence of another condition able to explain the findings
(6) misdiagnosis
In a patient with unexplained complaints then the possibility of celiac disease should be included in the differential diagnosis.
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Specialty: Gastroenterology