Celiac Disease Case Finding Strategy in Romanian Symptomatic Children (original) (raw)
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Romanian experience in child celiac disease diagnosis
Roumanian archives of microbiology and immunology
Last consensus in celiac disease in 2008 conducted under the aegis of the European Society of Pediatric Gastroenterology, Hepatology and Nutrition jointly with North American Society of Pediatric Gastroenterology, Hepatology and Nutrition reveals the following: "celiac disease is a chronic immune-mediated enteropathy characterized by sensitization to gluten. That can affect any organ or system, with a wide range of clinical manifestations of variable severity". Thus, in recent years, clinical picture of celiac disease has changed the old paradigm--bowel disease with villous atrophy and malnutrition, being replaced with the new paradigm--multi-organ autoimmune disease, affecting many organs and systems throughout but with more less specific symptoms, which undiagnosed leads to delayed diagnosis, at a late-onset disease and long-term major complications as the risk of cancer. According to this consensus "the serological diagnosis of celiac disease is based on high sensi...
2021
The diagnosis of celiac disease (CD) may be delayed due to non-specific clinical symptoms. The aim of the study was to evaluate the clinical manifestation and diagnostic process of CD in Polish children and adults. Methods: The members of the Polish Coeliac Society (n=2 500) were asked to complete a questionnaire on socio-demographic factors, clinical and diagnostic aspects of CD. The analysis was based on 796 responses from patients with confirmed CD diagnosis, and included 224 (28.1%) children and 572 (71.9%) adults. Results: The mean duration of symptoms prior to CD diagnosis in children was significantly shorter than in adults (p < 0.001), and amounted to 3.1 and 9 years respectively. The most frequent symptoms before CD diagnosis were abdominal pain and bloating in children (70.4%), and chronic fatigue in adults (74.5%). Although almost all CD patients claimed to strictly avoid gluten after CD diagnosis, symptoms were still present in the majority of these respondents. No co...
Value of clinical data in diagnosis of symptomatic celiac disease in children
Annals of the College of Medicine, Mosul
Objective: To identify the value of clinical data in diagnosis of celiac disease (CD) in children. Patients and methods: a prospective study was conducted in Mosul city during the period from 30 th of October 2007 to 30 th of April 2011. A total of 57 patients (39 males, 18 females) aged more than 6 months on gluten containing diet presented with symptoms suggestive of (CD) were evaluated clinically and serologically using IgA human recombinant tissue transglutaminase antibody. (IgA anti tTG2). Multiple duodenal biopsies were performed for every patient enrolled in this study. CD cases had been followed up 6 months after a gluten free diet (GFD) by weight measurement and the mentioned serological testing. Results: A total of 29 (50.9%) out of 57 symptomatic patients with mean age of 56.1 months, demonstrated positive biopsy results for celiac disease. Failure to thrive (FTT) was noticeable in 25 (86.2%) of studied patients with celiac disease followed by anemia, abdominal distension, offensive stool and chronic diarrhea in decreasing frequency. Catch up of weight was not achieved in 10 (43.5%) out of 23 CD patients with FTT whose (IgA anti tTG2) normalized after 6 months of GFD. Conclusions: The diagnosis of celiac disease on the basis of clinical features alone was incorrect in (49.1%) cases, indicating that diagnosis and lifelong GFD treatment is not justifiable relying on clinical data. Catch up of weight cannot be relied upon as an early marker of clinical improvement in patients with proven adherence to GFD. The result of this study emphasizes the importance of increasing awareness of the accurate tools in diagnosis of CD in children based on serological and biopsy evidences.
Romanian Journal of Pediatrics
Background. The clinical characteristics of patients with celiac disease cover a wide range of signs and symptoms. Our study aimed to describe the main clinical features and investigations performed on our celiac patients diagnosed in the past five years. Material and methods. We collected data from medical records of patients aged 0 to 18 years diagnosed with celiac disease. We included in the analysis patients newly diagnosed with celiac disease, in our department, between January 2017 and August 2022. Results. In this period, 30 children were diagnosed with celiac disease in our general pediatrics department. The mean age at diagnosis ± standard deviation was 6.3±4.2 years (median age=4.3 years). The period between onset of symptoms ranged between 3 months to 5 years (median=6 months). Twenty children (66%) had features of classical celiac disease. Thirteen/30 patients (43.3%) were found to have iron deficiency anemia at diagnosis. In 23/30 (76%) of the children, the values of th...
Diagnóstico de enfermedad celiaca en la práctica clínica: presente y futuro
Anales de Pediatría, 2020
Introduction: European guidelines for the diagnosis of celiac disease (CD) have been updated in 2020. The primary objective was to review the compliance with the diagnostic criteria for CD, according to ESPGHAN 2012. Secondarily, to describe the clinical characteristics of the patients and to assess the changes that would be implied by the application of the new 2020 criteria. Patients and methods: Retrospective multicenter study in which 10 centers participated. Patients from 0 to 16 years old with a new diagnosis of CD in 2018-2019 were included. Clinical, serological variables and the performance of intestinal biopsy (IB) were collected.
Celiac Disease Phenotype in Clinically Diagnosed Romanian Adults and Children
Maedica, 2016
Once considered a disease of childhood, celiac disease (CD) is now seen quite frequently in adults also, but with different and various clinical presentation. Little data is currently available about pediatric and adult CD features in Romanian patients. 38 newly-diagnosed CD patients (17 adults and 21 children) were recruited for this study. The two groups (adult and pediatric) were compared regarding demographic, clinical, serologic and histological data. Regarding demographic data, female gender was predominant in both groups (71% and 67% respectively). Median age was 42 (range 23-83) in the adult CD group and 4 (1-17) in the pediatric CD group. Classic presentation was more frequently seen in children than adults (62% vs. 53%). Altered liver function tests, anemia and iron deficiency were more prevalent in the pediatric group. Children with CD also had higher titers of tTG antibodies (81% over 200 U/l, compared to 29% adults) and a higher frequency of destructive histology on sma...
Optimization of serologic diagnosis of celiac disease in the pediatric setting
Autoimmunity Reviews
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