ArticleThe American journal of gastroenterology2015
Evaluation of the ESPGHAN Celiac Guidelines in a North American Pediatric Population.
Article in The American journal of gastroenterology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled it.
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Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it, 84 citations in OpenAlex.
- A systematic review of guidelines on screening for celiac disease in children with thyroid disease and vice versa.Frontiers in pediatrics · 2025Pooled it
- Defining the optimum strategy for identifying adults and children with coeliac disease: systematic review and economic modelling.Health technology assessment (Winchester, England) · 2022Pooled it
- Frequency of follow-up testing for tissue transglutaminase antibodies after initial positivity among children: An analysis of real-world data from a population-based cohort in Canada.Journal of the Canadian Association of Gastroenterology · 2026Article
- Article
- Applicability of ESPGHAN Biopsy-Free Guidelines for Celiac Disease Diagnosis: Insights from Türkiye.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2025Article
- Insights into coeliac disease diagnosis: a 2021-2023 overview of diagnostic approach and delays in children in Slovenia.Wiener medizinische Wochenschrift (1946) · 2024Article
- Predictors of celiac disease in patients with type 1 diabetes and positive tissue transglutaminase immunoglobulin A.Journal of pediatric gastroenterology and nutrition · 2024Article
- Performance of deamidated gliadin peptide antibodies as first screening for celiac disease in the general pediatric population.Frontiers in pediatrics · 2023Article
- Evaluation of Celiac Disease by Minimally Invasive Biomarkers in a Spanish Pediatric Population.International journal of environmental research and public health · 2022Article
- Exome Sequencing Identifies the Extremely RareFrontiers in pediatrics · 2022Article
- Clinical Presentation of Celiac Disease and Diagnosis Accuracy in a Single-Center European Pediatric Cohort over 10 Years.Nutrients · 2021Article
- Article
- Value of biopsy in a cohort of children with high-titer celiac serologies: observation of dynamic policy differences between Europe and North America.BMC health services research · 2020Observational
- Discordance Between Serology and Histology for Celiac Disease in a Cohort with Coexisting Liver Disorders.Journal of the Canadian Association of Gastroenterology · 2020Article
- Survey of the initial management of celiac disease antibody tests by ordering physicians.BMC pediatrics · 2019Observational
- Beneficial effects of gluten free diet on IgA tissue transglutaminase levels and various growth parameters in celiac disease patients.Journal of family medicine and primary care · 2019Article
- Coeliac screening in a high-risk population: paediatric type 1 diabetes-a review of current guidelines and practice.Irish journal of medical science · 2019Article
- Diagnosing Celiac Disease: Towards Wide-Scale Screening and Serology-Based Criteria?Gastroenterology research and practice · 2019Review
- Coeliac disease: to biopsy or not?Nature reviews. Gastroenterology & hepatology · 2018Review
- The serological diagnosis of coeliac disease - a step forward.Gastroenterology and hepatology from bed to bench · 2018Review
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesWe retrospectively examined the performance of the tissue transglutaminase (TTG), endomysial antibody (EMA) tests, and the ESPGHAN (European Society of Paediatric Gastroenterology, Hepatology and Nutrition) nonbiopsy criteria in a pediatric population.
methodsConsecutive celiac serologies and corresponding intestinal biopsy results were obtained on children <18 years old over 3.5 years. Patients were classified into three categories: positive TTG, negative TTG, and IgA deficiency.
resultsOf the 17,505 patients with celiac serology performed, 775 had a positive TTG, 574 with a negative TTG were biopsied, and 25 were IgA deficient. Of the patients with a TTG ≥10 × upper limit of normal (ULN), positive EMA, and symptoms, 98.2% had biopsies consistent with celiac disease (CD). Four human leukocyte antigen (HLA) DQ2/DQ8-positive patients who met the ESPGHAN nonbiopsy criteria did not have CD. In the group with a TTG 3-10 × ULN, 75.7% EMA-positive patients and only 40% EMA-negative patients had CD (P<0.001). Of those with a TTG 1-3 × ULN, 52.2% EMA-positive patients vs. only 13.3% EMA-negative patients had CD (P<0.01). Of the patients with bulbar and duodenal biopsies, 9.8% had CD confined only in the bulb, especially those with a low titer TTG (P<0.01). CD prevalence in our cohort was 34.6%. Sensitivity, specificity, and positive predictive value of the TTG were 98.7%, 86.4%, and 79.4%, respectively.
conclusionsThe TTG is a very sensitive screen for CD, but positive predictive value improves with a positive EMA titer. To apply the new ESPGHAN guidelines, clinicians must understand the performance of their celiac serology tests.
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