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IMPROVED ADHERENCE TO THE ESPGHAN GUIDELINES IS NECESSARY FOR DIAGNOSING CELIAC DISEASE IN CHILDREN: A SINGLE-CENTER EXPERIENCE
- Source :
- Arquivos de Gastroenterologia, Vol 58, Iss 2, Pp 164-167 (2021)
- Publication Year :
- 2021
- Publisher :
- Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia (IBEPEGE), 2021.
-
Abstract
- ABSTRACT BACKGROUND: Celiac disease (CD) is an immune-mediated systemic disorder elicited by the ingestion of gluten. The European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) guidelines published in 2012 suggested a no-biopsy pathway (NBP) for symptomatic children with IgA tissue transglutaminase (TGA-IgA) ≥10x upper limit of normal (ULN). Biopsy confirmation remained mandatory for other cases. OBJECTIVE: This retrospective case note study was aimed at evaluating the adherence to the ESPGHAN 2012 guidelines for diagnosing CD in our unit. METHODS: Forty-three cases with positive TGA-IgA were identified by a laboratory database search from January 2013 to December 2019. 6 of 43 patients were not referred for a confirmation of CD diagnosis. Data was collected on the diagnostic pathways followed, and appropriateness of adherence was compared with the existing ESPGHAN guidelines. RESULTS: A total of 37 cases were included with 35 children diagnosed with CD. 29/35 (83%) were diagnosed via the NBP;15/29 (52%) children did not meet all the criteria required for NBP, but were diagnosed and managed as having CD. 20/35 (57%) children were diagnosed with CD in adherence to the 2012 guidelines. CONCLUSION: The recommended diagnostic guidelines were frequently not implemented; adherence to the guidelines may improve following regular educational sessions. The revised 2020 ESPGHAN guidelines which exclude HLA-DQ2/DQ8 testing would address the issue of diagnosis for the 10/15 NBP cases (with TGA-IgA >10xULN) in our study who did not have HLA testing and were therefore non-adherent to the 2012 diagnostic guidelines. NBP, with the reduced need for endoscopy may be beneficial in resource limited settings.
- Subjects :
- Diseases of the digestive system. Gastroenterology
RC799-869
Subjects
Details
- Language :
- English
- ISSN :
- 16784219 and 00042803
- Volume :
- 58
- Issue :
- 2
- Database :
- Directory of Open Access Journals
- Journal :
- Arquivos de Gastroenterologia
- Publication Type :
- Academic Journal
- Accession number :
- edsdoj.1b363ad2b44d42549cb3a718a2197a14
- Document Type :
- article
- Full Text :
- https://doi.org/10.1590/s0004-2803.202100000-28