Abstract:
OBJECTIVES:A large retrospective multicentre study was conducted in Spain to evaluate the efficiency of the new European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) criteria for the diagnosis of coeliac disease (CD). METHODS:The study protocol was approved by the ethics committee of Hospital Universitari i Politècnic La Fe (Valencia, Spain). The present study included 2177 children (ages 0.6-15.9 years) with small bowel biopsy (SBB) performed for diagnostic purposes (from 2000 to 2009) and with a minimum 2-year follow-up after biopsy. RESULTS:CD was diagnosed in 2126 patients (97.5%) and excluded in 51 (2.5%). Tissue transglutaminase antibodies (TG2A), anti-endomysial antibodies (EMA), and human leukocyte antigen (HLA) were reported in 751 patients, 640 symptomatic and 111 asymptomatic. TG2A levels >10 times the upper limit of normal, plus positive EMA and HLA DQ2 and/or DQ8 haplotypes, were found in 336 symptomatic patients, all of them with final diagnosis of CD. In 65 of 69 asymptomatic patients, 65 had confirmed CD and 4 did not have CD. According to the 2012 ESPGHAN guidelines, SBB may have been omitted in 52% of the symptomatic patients with CD with serologic and HLA available data. Gluten challenge was performed in 158 children, 75 of them <2 years at first biopsy. Only 1 patient in whom according to the new proposed diagnostic criteria gluten challenge would not have been mandatory did not relapse. CONCLUSIONS:Our results support the new ESPGHAN 2012 guidelines for diagnosis of CD can be safely used without the risk of overdiagnosis. A prospective multicentre study is needed to confirm our results.
journal_name
J Pediatr Gastroenterol Nutrjournal_title
Journal of pediatric gastroenterology and nutritionauthors
Donat E,Ramos JM,Sánchez-Valverde F,Moreno A,Martinez MJ,Leis R,Peña-Quintana L,Castillejo G,Fernández S,Garcia Z,Ortigosa L,Balmaseda E,Marugán JM,Eizaguirre FJ,Lorenzo H,Barrio J,Ribes-Koninckx C,SEGHNP Working Groupdoi
10.1097/MPG.0000000000000870subject
Has Abstractpub_date
2016-02-01 00:00:00pages
284-91issue
2eissn
0277-2116issn
1536-4801journal_volume
62pub_type
杂志文章,多中心研究abstract::Pseudomembranous colitis secondary to C. difficile and its toxin(s) is a well-recognized disease in children and usually responds to treatment with oral vancomycin. There are well-documented reports of relapse in adults after initial successful treatment with vancomycin. This report documents relapse in a child who de...
journal_title:Journal of pediatric gastroenterology and nutrition
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journal_title:Journal of pediatric gastroenterology and nutrition
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journal_title:Journal of pediatric gastroenterology and nutrition
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doi:10.1097/00005176-198512000-00011
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journal_title:Journal of pediatric gastroenterology and nutrition
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doi:10.1097/00005176-200404000-00009
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journal_title:Journal of pediatric gastroenterology and nutrition
pub_type: 杂志文章,实务指引,评审
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journal_title:Journal of pediatric gastroenterology and nutrition
pub_type: 杂志文章
doi:10.1097/MPG.0b013e3181e85b55
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journal_title:Journal of pediatric gastroenterology and nutrition
pub_type: 杂志文章
doi:10.1097/MPG.0b013e3181826daf
更新日期:2008-11-01 00:00:00
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journal_title:Journal of pediatric gastroenterology and nutrition
pub_type: 杂志文章,多中心研究
doi:10.1097/00005176-199708000-00004
更新日期:1997-08-01 00:00:00
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journal_title:Journal of pediatric gastroenterology and nutrition
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doi:10.1097/MPG.0000000000002521
更新日期:2020-02-01 00:00:00
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journal_title:Journal of pediatric gastroenterology and nutrition
pub_type: 杂志文章
doi:10.1097/00005176-198807000-00018
更新日期:1988-07-01 00:00:00
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journal_title:Journal of pediatric gastroenterology and nutrition
pub_type: 杂志文章
doi:10.1097/MPG.0000000000002799
更新日期:2020-08-01 00:00:00
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journal_title:Journal of pediatric gastroenterology and nutrition
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journal_title:Journal of pediatric gastroenterology and nutrition
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journal_title:Journal of pediatric gastroenterology and nutrition
pub_type: 杂志文章
doi:10.1097/00005176-198611000-00015
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journal_title:Journal of pediatric gastroenterology and nutrition
pub_type: 临床试验,杂志文章
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journal_title:Journal of pediatric gastroenterology and nutrition
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更新日期:2011-01-01 00:00:00
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更新日期:2013-10-01 00:00:00
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journal_title:Journal of pediatric gastroenterology and nutrition
pub_type: 杂志文章,随机对照试验
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更新日期:2008-03-01 00:00:00
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journal_title:Journal of pediatric gastroenterology and nutrition
pub_type: 杂志文章
doi:10.1097/mpg.0b013e31818936b8
更新日期:2009-03-01 00:00:00
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journal_title:Journal of pediatric gastroenterology and nutrition
pub_type: 杂志文章
doi:10.1097/00005176-199001000-00019
更新日期:1990-01-01 00:00:00
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journal_title:Journal of pediatric gastroenterology and nutrition
pub_type: 杂志文章
doi:10.1097/MPG.0b013e31818f09f2
更新日期:2009-09-01 00:00:00
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journal_title:Journal of pediatric gastroenterology and nutrition
pub_type: 杂志文章
doi:10.1097/MPG.0b013e3182758c69
更新日期:2013-02-01 00:00:00