657 Severe Malabsorption Associated With Olmesartan: A French Nationwide Cohort Study

diabetes, 1st degree relative with CD, autoimmune diseases) accounted for the remainder.Only 43.2% of indicated CD screening was performed; luminal GI clinic tested 53.5%, IBD clinic tested 39.2%, hepatology tested 27%, and biliary clinic tested 34.3%.Anti-tissue transglutaminase IgA was performed in 68.7% (0.04% abnormal), quantitative IgA level in 48.2% (0.05% abnormal), antigliadin antibody in 30.1% (0.02% abnormal), endomysial antibody in 44% (0.04% abnormal), and deamidated gliadin peptide in 12% (all normal).Duodenal biopsy was performed by the referring doctor in 36%, after serology in 9%, and before serology in 8.4% of patients.Of 166 patients screened, 4 patients (2.4%) had serology consistent with CD, of which 2 were proven by duodenal biopsy.Using this proportion, an additional 4 patients could have been diagnosed in 170 unscreened patients.Based on our results, need for testing is highest in the luminal GI and IBD clinics, followed by biliary, and lowest in hepatology (p<0.0001).Screening rate is highest in luminal GI clinic (p= 0.002).CONCLUSIONS: Greater than half of patients seen in a tertiary GI clinic have indications for CD screening, but less than half of indicated cases are actually screened.Case-finding techniques are therefore suboptimal, constituting a gap in patient care and an important target for future quality improvement initiatives.The value of screening may be enhanced in populations with higher prevalence of CD.