ArticleBMC gastroenterology2017
Diagnosis of celiac disease and applicability of ESPGHAN guidelines in Mediterranean countries: a real life prospective study.
Article in BMC gastroenterology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed, 30 citations in OpenAlex.
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- Celiac disease diagnosis: transglutaminase, duodenal biopsy and genetic tests correlations.Frontiers in pediatrics · 2024Article
- Evaluation of Celiac Disease by Minimally Invasive Biomarkers in a Spanish Pediatric Population.International journal of environmental research and public health · 2022Article
- Celiac Disease With Autoimmune Hemolytic Anemia and Autoimmune Hepatitis in a Young Child: Case Report and Literature Review.Clinical medicine insights. Pediatrics · 2022Article
- Disease specific symptoms indices in patients with celiac disease-A hardly recognised entity.Frontiers in nutrition · 2022Article
- Clinical Presentation of Celiac Disease and Diagnosis Accuracy in a Single-Center European Pediatric Cohort over 10 Years.Nutrients · 2021Article
- Association between intestinal neoplasms and celiac disease: A review.World journal of gastrointestinal oncology · 2021Review
- Celiac disease in children: Increasing prevalence and changing clinical presentations.Clinical and experimental pediatrics · 2021Article
- Diagnosis of Celiac Disease: Taking a Bite Out of the Controversy.Digestive diseases and sciences · 2018Review
- Clinicopathological and immunological characteristics and outcome of concomitant coeliac disease and non-alcoholic fatty liver disease in adults: a large prospective longitudinal study.BMJ open gastroenterology · 2018Article
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Authors and funding
16 authors at 14 institutions in 13 countries.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundWe assessed how the diagnosis of Celiac Disease (CD) is made and how the new ESPGHAN guidelines can be applied in children from countries with different resources.
methodsA real life prospective study was performed in 14 centres of 13 different Mediterranean countries. Participants were asked to apply the usual diagnostic work-up for CD according to their diagnostic facilities.
resultsThere were 1974 patients enrolled in the study, mean age 4 years, 10 months; 865 male, 1109 female. CD was confirmed in 511 (25.9%) and was unconfirmed in 1391 (70.5%) patients; 14 patients were diagnosed as having CD according to the new ESPGHAN guidelines, 43 patients were classified as having potential CD. In all participating countries the diagnosis of CD relied on histology of duodenal biopsy; in 5 countries, HLA, and in one country endomysial antibodies (EMA) were not available. Symptoms did not add a significant increase to the pre-test probability of serological tests. The positive predictive value of tissue transglutaminase type 2 (tTG) antibodies performed with different kits but all corresponding to those recommended by ESPGHAN was 96.1% (95% CI 94-97.9%) in presence of tTG > 10xULN. In 135 patients with tTG >10xULN, HLA genotyping was performed and in all it was compatible with CD.
conclusionsThe results of our study show that CD diagnosis still relies on intestinal biopsy in the Mediterranean area. New ESPGHAN criteria are not applicable in 5 countries due to lack of resources needed to perform HLA genotyping and, in one country, EMA assay. Further simplification of the new ESPGHAN guidelines might be made according to what preliminarily the present results suggest if confirmed by new prospective studies.
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