BACKGROUND: @entity66 is common yet often undiagnosed because symptoms may be trivial, non-specific, or non-gastrointestinal, or because of lack of clinician awareness. Serum IgA-class @entity465 ( @entity465 ) have high specificity for @entity66 and may facilitate case-finding by clinicians other than gastroenterologists. We assessed the appropriateness and diagnostic yield of of requests for @entity465 by primary care general practitioners in a defined geographic area of Northern Ireland. METHODS: We identified @entity1 who had @entity465 examination requests by their general practitioners during 1994-1996. Individual @entity1 questionnaires were posted to the general practitioners concerned, seeking information on indications for testing, management after the result, and final diagnosis. We compared new @entity1 diagnosis rates in two catchment areas, one served by a large district general hospital with, and the other by smaller hospitals without, a medical gastroenterology facility. RESULTS: A total of 239 @entity1 had coeliac profile testing by 69 of 177 general practitioners in the area. Data were available for 181 @entity1 not previously known to have @entity66 , of whom 20 (11%) had @entity465 . All @entity2113 @entity1 were referred to hospital, where 19 underwent small-bowel biopsy, which confirmed @entity66 in all 19. Only 7 (35%) of the 20 had @entity294 , and there was no significant difference in @entity465 prevalence among @entity1 tested with and without @entity294 . Although the mean number of new @entity1 (per 100,000 population annually) diagnosed by biopsy was 11 at the large hospital compared with 5 elsewhere, the numbers identified by @entity465 in general practice for the 2 catchment areas were similar (2 and 3, respectively). CONCLUSION: General practitioners have an important role in the identification of @entity1 with @entity66 , particularly where there is no local medical gastroenterology facility, and this is facilitated by @entity465 testing.

Identification of XXXX in primary care.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity66 :: ('MESH:D004194', 'Disease') :: ['Coeliac disease', 'coeliac disease'] @entity294 :: ('MESH:D003967', 'Disease') :: ['diarrhoea'] @entity465 :: ('MESH:D007153', 'Disease') :: ['EmA', 'endomysial antibodies'] @entity2113 :: ('MESH:D006679', 'Disease') :: ['EmA-positive']
@entity66 :: (MESH:D004194,Disease) :: ['coeliac disease']
