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Outcome in pediatric celiac disease is independent of the diagnostic approach in patients with high antibody levels.
- Source :
-
Journal of pediatric gastroenterology and nutrition [J Pediatr Gastroenterol Nutr] 2024 Jul; Vol. 79 (1), pp. 84-91. Date of Electronic Publication: 2024 May 20. - Publication Year :
- 2024
-
Abstract
- Objectives: European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) guidelines enable the diagnosis of celiac disease (CD) without biopsies in patients with immunoglobulin A (IgA)-antibodies against tissue transglutaminase (TGA-IgA) ≥ 10× the upper limit of normal (ULN) and positivity of endomysial antibodies in a second blood sample. Limited data exist comparing the biopsy versus the nonbiopsy diagnostic approach regarding long-term outcomes in CD patients. Our study aimed to investigate the influence of the diagnostic approach on adherence to gluten-free diet (GFD), serological remission (defined as normalization of TGA-IgA during follow-up (FU)) and clinical remission in CD patients with TGA-IgA ≥ 10× ULN.<br />Methods: Retrospective multicenter study. Patients with CD and TGA-IgA ≥ 10× ULN at diagnosis were included in the study. Patients with confirmed diagnosis by biopsy were compared to patients diagnosed by nonbiopsy approach using univariate analysis, Kaplan-Meier survival curve, and logistic regression models.<br />Results: A total of 282 CD patients (192 [68.1%] in the biopsy group; 90 [31.9%] in the nonbiopsy group) were analyzed. The median time to normalization of TGA-IgA was 16.5 months [interquartile range, IQR: 13, 28] in the biopsy and 15 months [IQR: 12, 26] in the nonbiopsy group; p = 0.14). Rates of normalized TGA-IgA at first to third-year FU were comparable between both groups. Adherence to GFD did not seem to be influenced by the diagnostic approach.<br />Conclusions: The nonbiopsy approach is not inferior to the biopsy approach in terms of adherence to GFD and serological remission in patients with CD.<br /> (© 2024 European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.)
- Subjects :
- Humans
Retrospective Studies
Male
Child
Female
Biopsy
Child, Preschool
Adolescent
Autoantibodies blood
Protein Glutamine gamma Glutamyltransferase 2
GTP-Binding Proteins immunology
Treatment Outcome
Follow-Up Studies
Infant
Patient Compliance
Celiac Disease diagnosis
Celiac Disease diet therapy
Celiac Disease blood
Celiac Disease immunology
Diet, Gluten-Free
Transglutaminases immunology
Immunoglobulin A blood
Subjects
Details
- Language :
- English
- ISSN :
- 1536-4801
- Volume :
- 79
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of pediatric gastroenterology and nutrition
- Publication Type :
- Academic Journal
- Accession number :
- 38769762
- Full Text :
- https://doi.org/10.1002/jpn3.12251