Reviewer's report
Title:The changing clinical profile of celiac disease: a 15-year experience
(1998-2012) in an Italian referral center
Version:3Date:6 October 2014
Reviewer: Geoffrey Holmes
Reviewer's report:
This is an interesting study from a single centre in Italy of 770 adult patients with
coeliac disease (CD) diagnosed between Jan 1998 and Dec 2012. The aim was
to define clinical presentations, response to GFD and complications. It contains
much useful information of interest to all those who have an interest in CD,
I have some comments:
Major
1. The final sentence of the paper indicates that this is a retrospective survey and
this should be stated in the Methods section. Information was obtained from a
review of the hospital notes which I presume were available in all cases.
2. In the presentation of results information given has been duplicated in the text
and the figures. For instance Figures 4 and 5 could be left out or the text
amended to avoid repetition. The authors should look at this with regard to all the
figures and accompanying text. This would allow the paper to be shortened
considerably without losing any important information.
3. How was the recorded symptom(s) of patients determined? Most patients have
multiple symptoms. I notice that the symptoms in the abstract and page 8 add to
more that 100%.
4. In the Discussion it is stated that from their data a diagnosis of CD always
requires a biopsy. They say that a minority of cases with high titre anti-TG2 had
non- atrophic mucosa. But we need to know what the titres were in relation to the
upper limit of normal for the test. Also we need to know what test kit was used
since some have poor performance and should never be used. There is now
much evidence that in spite of the recently published BSG guidelines, a
serological diagnosis of CD can be safely made in a sub group of patients. The
pediatricians have now formally recognised this in the ESPGHAN guidelines thay
have produced. This is currently a very important issue for clinicians and if the
authors cannot substantiate it firmly they should delete this statement to avoid
confusion.
Minor
1. I am surprised that continuing GERD is regarded as non-responsive coeliac
disease.
2. No patient had associated inflammatory bowel disease which is a little
surprising
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I declare that I have no competing interests
Reviewer's report
Title:The changing clinical profile of celiac disease: a 15-year experience
(1998-2012) in an Italian referral center
Version:3Date:6 October 2014
Reviewer: Geoffrey Holmes
Reviewer's report:
This is an interesting study from a single centre in Italy of 770 adult patients with
coeliac disease (CD) diagnosed between Jan 1998 and Dec 2012. The aim was
to define clinical presentations, response to GFD and complications. It contains
much useful information of interest to all those who have an interest in CD,
I have some comments:
Major
1. The final sentence of the paper indicates that this is a retrospective survey and
this should be stated in the Methods section. Information was obtained from a
review of the hospital notes which I presume were available in all cases.
2. In the presentation of results information given has been duplicated in the text
and the figures. For instance Figures 4 and 5 could be left out or the text
amended to avoid repetition. The authors should look at this with regard to all the
figures and accompanying text. This would allow the paper to be shortened
considerably without losing any important information.
3. How was the recorded symptom(s) of patients determined? Most patients have
multiple symptoms. I notice that the symptoms in the abstract and page 8 add to
more that 100%.
4. In the Discussion it is stated that from their data a diagnosis of CD always
requires a biopsy. They say that a minority of cases with high titre anti-TG2 had
non- atrophic mucosa. But we need to know what the titres were in relation to the
upper limit of normal for the test. Also we need to know what test kit was used
since some have poor performance and should never be used. There is now
much evidence that in spite of the recently published BSG guidelines, a
serological diagnosis of CD can be safely made in a sub group of patients. The
pediatricians have now formally recognised this in the ESPGHAN guidelines thay
have produced. This is currently a very important issue for clinicians and if the
authors cannot substantiate it firmly they should delete this statement to avoid
confusion.
Minor
1. I am surprised that continuing GERD is regarded as non-responsive coeliac
disease.
2. No patient had associated inflammatory bowel disease which is a little
surprising
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I declare that I have no competing interests
Please review this paper.
user
Reviewer's report
Title:The changing clinical profile of celiac disease: a 15-year experience
(1998-2012) in an Italian referral center
Version:3Date:6 October 2014
Reviewer: Geoffrey Holmes
Reviewer's report:
This is an interesting study from a single centre in Italy of 770 adult patients with
coeliac disease (CD) diagnosed between Jan 1998 and Dec 2012. The aim was
to define clinical presentations, response to GFD and complications. It contains
much useful information of interest to all those who have an interest in CD,
I have some comments:
Major
1. The final sentence of the paper indicates that this is a retrospective survey and
this should be stated in the Methods section. Information was obtained from a
review of the hospital notes which I presume were available in all cases.
2. In the presentation of results information given has been duplicated in the text
and the figures. For instance Figures 4 and 5 could be left out or the text
amended to avoid repetition. The authors should look at this with regard to all the
figures and accompanying text. This would allow the paper to be shortened
considerably without losing any important information.
3. How was the recorded symptom(s) of patients determined? Most patients have
multiple symptoms. I notice that the symptoms in the abstract and page 8 add to
more that 100%.
4. In the Discussion it is stated that from their data a diagnosis of CD always
requires a biopsy. They say that a minority of cases with high titre anti-TG2 had
non- atrophic mucosa. But we need to know what the titres were in relation to the
upper limit of normal for the test. Also we need to know what test kit was used
since some have poor performance and should never be used. There is now
much evidence that in spite of the recently published BSG guidelines, a
serological diagnosis of CD can be safely made in a sub group of patients. The
pediatricians have now formally recognised this in the ESPGHAN guidelines thay
have produced. This is currently a very important issue for clinicians and if the
authors cannot substantiate it firmly they should delete this statement to avoid
confusion.
Minor
1. I am surprised that continuing GERD is regarded as non-responsive coeliac
disease.
2. No patient had associated inflammatory bowel disease which is a little
surprising
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I declare that I have no competing interests
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