Compatibility between the National Celiac Disease Protocol and the Local Database Registration Method Based on Clinical Manifestations and Laboratory

Zahra Ebrahimi, Alireza Norouzi, Sima Besharat, Ali Jafari, Honeyeh-sadat Mirkarimi



The Celiac National Institute has recently devised a diagnostic algorithm for celiac, which has been adopted from the most recent guidelines and articles worldwide. All Iranian provinces are requested to set all diagnoses based on the newest national protocol devised by the National Institute of Celiac Disease; however, some incompatibilities are observed. Therefore, this study was conducted to demonstrate these incompatibilities.

Materials and Methods :  

In this descriptive-analytical study, we enrolled 250 cases of celiac disease referred to the province registry system and revised the diagnosis based on the national protocol for celiac disease diagnosis. All data were analyzed using SPSS software version 26.


Among the 250 patients diagnosed with celiac disease, 88 (35.2%) had incompatibility. The mean age of the patients was 37.19 years. 28 people (31.8 %) were men. Results indicated that in 40.9% of incompatibility cases, only pathology tests were performed, and in 52.3% of incompatibility cases, only serological tests were performed. In 6.8% of cases, both tests were performed, but the diagnosis was indefinite. Pathological results indicated that 0.5% of patients were in Marsh 1, 19% in Marsh 2, 35.7% in 3a, 23.8% in 3b, and 19% in Marsh 3c phases.


There are cases of diagnostic incompatibilities between the most recent national protocol for celiac disease and physicians’ practice. Therefore, it is vital that practitioners are trained with the national protocol for celiac disease diagnosis.


Celiac disease, Misdiagnosis, Iran

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