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Background Coeliac disease (CD) is a systemic immune-mediated disorder caused by the ingestion of gluten and related prolamines in genetically predisposed individuals. The 2012 ESPGHAN guidelines suggested a no-biopsy pathway (NBP) for symptomatic children with IgA-based Tissue Transglutaminase (TGA-IgA) -10x Upper Limit of Normal (ULN). Biopsy confirmation remained mandatory for all other cases. Objectives This retrospective case note study was aimed at evaluating the extent of adherence to the ESPGHAN 2012 guidelines for diagnosing CD in our unit. Methods 179 cases with positive TGA-IgA were identified from the laboratory database between January'2013 to December' 2020. 17/179 (9%) patients were not referred to secondary care after the finding of positive TTG in primary care. Data was collected on the diagnostic pathways followed, and adherence was compared with the existing ESPGHAN 2012 guidelines. Results 129 cases assessed for CD were included and 124 children diagnosed with CD. 68/129 (53%) were diagnosed via the NBP. 57/68 were diagnosed via NBP until December 2019 and 24/57 (42%) children did not meet triple criteria as per 2012 ESPGHAN guidelines. HLA-DQ2/DQ8 testing wasn't done for 16/57 NBP cases and other 3/57 had a negative EMA result. In 2020, 13 patients were diagnosed via NBP, 11 in adherence to the 2020 ESPGHAN guidelines, other 2 [TGA-IgA

Corticosteroids are a potent class of drugs that, since their discovery, have become a cornerstone of therapy in many areas of medical practice. Their range of anti-inflammatory and immune modulating actions make them an attractive option, however their use has to be balanced against a significant side effect profile which is well known in children and adults but has not been so extensively studied in preterm infants. Currently antenatal steroid therapy in expectant preterm deliveries has been shown to reduce neonatal morbidity and mortality and is recommended as standard therapy. Postnatal steroids on the neonatal unit have mainly been used in the treatment of hypotension and in the prevention/treatment of chronic lung disease. Despite evidence confirming that postnatal treatment with dexamethasone reduced the incidence of chronic lung disease major concerns about long-term neurological outcomes persist, resulting in a need for careful balancing of the risks and benefits. Systematic reviews and meta-analyses have looked at the evidence to clarify the most effective steroid; timing of administration; dose and route to further guide their safe and effective use. This article aims to provide a summary of the currently available evidence regarding the risks and benefits of steroid use in the neonatal intensive care unit and offer guidance for paediatricians.