Coeliac disease in the ERA of the new ESPGHAN and BSPGHAN guidelines: a prospective cohort study

被引:28
|
作者
Benelli, Elisa [1 ]
Carrato, Valentina [1 ]
Martelossi, Stefano [2 ]
Ronfani, Luca [2 ]
Not, Tarcisio [1 ,2 ]
Ventural, Alessandro [1 ,2 ]
机构
[1] Univ Trieste, Dept Med Surg & Hlth Sci, Via Istria 65, I-34137 Trieste, Italy
[2] IRCCS Burlo Garofolo, Inst Maternal & Child Hlth, Trieste, Italy
关键词
GLUTEN-FREE DIET; DIAGNOSIS; CHILDREN; POPULATION; ANTIBODIES; CRITERIA;
D O I
10.1136/archdischild-2015-309259
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
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, anti-transglutaminase 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, anti-transglutaminase 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.
引用
收藏
页码:172 / 176
页数:5
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