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Title: ESPGHAN 2012 guidelines for coeliac disease diagnosis: validation through a retrospective spanish multicentric study
Authors: Donat, Ester
García Ramos, J. M.
Sánchez-Valverde, Félix
Moreno, Ana
Martinez, M.-J.
Leis, Rosaura
Peña-Quintana, Luis 
Castillejo, Gemma
Garrote Fernández, Sonia
Garcia, Zuriñe
Ortigosa, Luís
Balmaseda, Elena
Marugán, José Manuel
Eizaguirre, Francisco Javier
Lorenzo, Helena
Barrio, Josefa
Ribes-Koninckx, Carmen
UNESCO Clasification: 3206 Ciencias de la nutrición
Keywords: Celiac disease
ESPGHAN 2012 diagnostic criteria
Issue Date: 2016
Journal: Journal of Pediatric Gastroenterology and Nutrition 
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.
ISSN: 0277-2116
DOI: 10.1097/MPG.0000000000000870
Source: Journal of Pediatric Gastroenterology and Nutrition[ISSN 0277-2116],v. 62, p. 284-291
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