TY - JOUR
T1 - Coeliac disease in the ERA of the new ESPGHAN and BSPGHAN guidelines
T2 - A prospective cohort study
AU - Benelli, Elisa
AU - Carrato, Valentina
AU - Martelossi, Stefano
AU - Ronfani, Luca
AU - Not, Tarcisio
AU - Ventura, Alessandro
PY - 2016/2/1
Y1 - 2016/2/1
N2 - Objective To evaluate the consequences of the last European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN) guidelines for the diagnosis of coeliac disease (CD) by means of a prospective study. Design Prospective cohort study. Setting Institute for Maternal and Child Health IRCCS Burlo Garofolo (Trieste, Italy). Patients Children diagnosed with CD without a duodenal biopsy (group 1), following the last ESPGHAN and BSPGHAN guidelines, and children diagnosed with a duodenal biopsy, matched for sex, age and year of diagnosis (group 2), were prospectively enrolled over a 3-year period. All patients were put on a gluten-free diet (GFD) and were followed up for clinical conditions and laboratory testing at 6 months every year since diagnosis (median follow up: 1.9 years). Outcome measures Resolution of symptoms, body mass index, laboratory testing (haemoglobin, antitransglutaminase IgA), adherence to a GFD, quality of life, and supplementary post-diagnosis medical consultations. Results 51 out of 468 (11%) patients were diagnosed without a duodenal biopsy (group 1; median age 2.1 years) and matched to 92 patients diagnosed with a biopsy (group 2; median age 2.4 years). At the end of follow-up the two groups were statistically comparable in terms of clinical and nutritional status, antitransglutaminase IgA antibody titres, quality of life, adherence to a GFD, and number of supplementary medical consultations. Conclusions On the basis of this prospective study, diagnosis of CD can be reliably performed without a duodenal biopsy in approximately 11% of cases. At least during a medium-term follow-up, this approach has no negative consequences relating to clinical remission, adherence to diet, and quality of life of children with CD.
AB - Objective To evaluate the consequences of the last European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN) guidelines for the diagnosis of coeliac disease (CD) by means of a prospective study. Design Prospective cohort study. Setting Institute for Maternal and Child Health IRCCS Burlo Garofolo (Trieste, Italy). Patients Children diagnosed with CD without a duodenal biopsy (group 1), following the last ESPGHAN and BSPGHAN guidelines, and children diagnosed with a duodenal biopsy, matched for sex, age and year of diagnosis (group 2), were prospectively enrolled over a 3-year period. All patients were put on a gluten-free diet (GFD) and were followed up for clinical conditions and laboratory testing at 6 months every year since diagnosis (median follow up: 1.9 years). Outcome measures Resolution of symptoms, body mass index, laboratory testing (haemoglobin, antitransglutaminase IgA), adherence to a GFD, quality of life, and supplementary post-diagnosis medical consultations. Results 51 out of 468 (11%) patients were diagnosed without a duodenal biopsy (group 1; median age 2.1 years) and matched to 92 patients diagnosed with a biopsy (group 2; median age 2.4 years). At the end of follow-up the two groups were statistically comparable in terms of clinical and nutritional status, antitransglutaminase IgA antibody titres, quality of life, adherence to a GFD, and number of supplementary medical consultations. Conclusions On the basis of this prospective study, diagnosis of CD can be reliably performed without a duodenal biopsy in approximately 11% of cases. At least during a medium-term follow-up, this approach has no negative consequences relating to clinical remission, adherence to diet, and quality of life of children with CD.
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U2 - 10.1136/archdischild-2015-309259
DO - 10.1136/archdischild-2015-309259
M3 - Article
C2 - 26578746
AN - SCOPUS:84956771750
VL - 101
SP - 172
EP - 176
JO - Archives of Disease in Childhood
JF - Archives of Disease in Childhood
SN - 0003-9888
IS - 2
ER -