Diagnosis of celiac disease is being missed in over 80% of children particularly in those from socioeconomically deprived backgrounds

Whitburn, Jessica; Rao, S. Madhusudana; Paul, Siba Prosad; Sandhu, Bhupinder

doi:10.1007/s00431-021-03974-8

Cited by 26 publications

(23 citation statements)

References 22 publications

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“…Second, the differences in follow-up recommendations reflect a relatively low interest in this topic in the past. Arguably, the search for more reliable diagnostic tools was the right priority in an era characterised by a severe under-diagnosis of CD .Nowadays, significant diagnostic delays can still occur in a minority of Central European children[ 82 ], with socioeconomically deprived children being more likely to be underdiagnosed despite improved and easily available serological testing[ 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…Celiac disease (CD) is an immune-mediated reaction to gluten characterised by an inflammatory injury to the small bowel in genetically predisposed subjects as a result of an inappropriate T cell-mediated immune response[ 1 ].The epidemiology of CD is well known, with an estimated worldwide prevalence of 0.6%-1% of the general population[ 2 ]. However, CD remains largely underdiagnosed in developing countries and has a higher impact on children[ 3 , 4 ]. Simultaneously, the misdiagnosis of CD is becoming an emergent problem worldwide[ 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Current guidelines for the management of celiac disease: A systematic review with comparative analysis

Raiteri¹,

Granito²,

Giamperoli³

et al. 2022

WJG

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BACKGROUND Wheat and other gluten-containing grains are widely consumed, providing approximately 50% of the caloric intake in both industrialised and developing countries. The widespread diffusion of gluten-containing diets has rapidly led to a sharp increase in celiac disease prevalence. This condition was thought to be very rare outside Europe and relatively ignored by health professionals and the global media. However, in recent years, the discovery of important diagnostic and pathogenic milestones has led to the emergence of celiac disease (CD) from obscurity to global prominence. These modifications have prompted experts worldwide to identify effective strategies for the diagnosis and follow-up of CD. Different scientific societies, mainly from Europe and America, have proposed guidelines based on CD's most recent evidence. AIM To identify the most recent scientific guidelines on CD, aiming to find and critically analyse the main differences. METHODS We performed a database search on PubMed selecting papers published between January 2010 and January 2021 in the English language. PubMed was lastly accessed on 1 March 2021. RESULTS We distinguished guidelines from 7 different scientific societies whose reputation is worldwide recognized and representative of the clinical practice in different geographical regions. Differences were noted in the possibility of a no-biopsy diagnosis, HLA testing, follow-up protocols, and procedures. CONCLUSION We found a relatively high concordance between the guidelines for CD. Important modifications have occurred in the last years, especially about the possibility of a no-biopsy diagnosis in children. Other modifications are expected in the next future and will probably involve the extension of the non-invasive diagnosis to the adult population and the follow-up modalities.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Current guidelines for the management of celiac disease: A systematic review with comparative analysis

Raiteri¹,

Granito²,

Giamperoli³

et al. 2022

WJG

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“…An epidemiological survey including school children, having similar genetic susceptibility and gluten intake, living in a prosperous area of Finland and in an adjacent unprivileged region of Russia, has suggested that worse socioeconomic conditions might protect against the development of CD 72 . Several European studies also have shown that children living in more socioeconomic deprived areas are less likely to be diagnosed with CD 162‐164 . High maternal education has also been linked to an increased risk of CD in the offspring 154 .…”

Section: Risk Factors For CDmentioning

confidence: 99%

Review article: Epidemiology of coeliac disease

Makharia

Chauhan

Singh

et al. 2022

Aliment Pharmacol Ther

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Coeliac disease is an immune-mediated disease caused by ingestion of gluten in genetically susceptible individuals. Coeliac disease has been thought to affect mainly people of European origin but subsequently many studies revealed that it affects people living in North America, Oceania, South America, Asia as well as Africa. The global pooled seroprevalence and prevalence of biopsy-confirmed coeliac disease are 1.4% and 0.7% respectively. The pooled incidence rates in women and men are 17.4 (95% CI: 13.7-21.1) and 7.8 (95% CI: 6.3-9.2) per 100 000 person-years respectively.The systematic reviews, based on many population-based data, suggest that both the prevalence and the incidence of coeliac disease has increased over past three decades, which may be attributable not only to an increase in the detection rate (improvement in diagnostic tests, simplification of diagnostic criteria and increase in awareness about the disease) but also because of modernisation and globalisation related changes in the dietary practices including increase in the use of convenience food and dietary gluten. In addition to genetic factors, while there are many environmental risk factors, including age at the first introduction of gluten, breastfeeding, caesarean section, exposure to antibiotics and gut microbiome; the amount of gluten ingestion during early part of life, however, has been shown to increase the risk of coeliac disease, and this is relevant from the point of view of primary prevention. In this review, we have reviewed and summarised the literature, up till year 2021, related to the global and continent-wise epidemiology and risk factors associated with coeliac disease.

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“…131,132,176 Notably, awareness raising appears to have had more limited impact on diagnoses in children. 177 Ensuring individuals affected by CD are recognised and offered suitable treatment options in a timely manner may be served most effectively by healthcare systems in high prevalence countries offering universal TG2 IgA serology screening to children after age ten years. Continuing current case-finding practices would address later onset and unrecognised CD in older individuals.…”

Section: Refractory Coeliac Diseasementioning

confidence: 99%

Review article: Diagnosis of coeliac disease: a perspective on current and future approaches

Anderson

2022

Aliment Pharmacol Ther

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Diagnostics will play a central role in addressing the ongoing dramatic rise in global prevalence of coeliac disease, and in deploying new non-dietary therapeutics. Clearer understanding of the immunopathogenesis of coeliac disease and the utility of serology has led to partial acceptance of non-biopsy diagnosis in selected cases. Non-biopsy diagnosis may expand further because research methods for measuring gluten-specific CD4+ T cells and the acute recall response to gluten ingestion in patients is now relatively straightforward. This perspective on diagnosis in the context of the immunopathogenesis of coeliac disease sets out to highlight current consensus, limitations of current practices, gluten food challenge for diagnosis and the potential for diagnostics that measure the underlying cause for coeliac disease, gluten-specific immunity.

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Diagnosis of celiac disease is being missed in over 80% of children particularly in those from socioeconomically deprived backgrounds

Cited by 26 publications

References 22 publications

Current guidelines for the management of celiac disease: A systematic review with comparative analysis

Current guidelines for the management of celiac disease: A systematic review with comparative analysis

Review article: Epidemiology of coeliac disease

Review article: Diagnosis of coeliac disease: a perspective on current and future approaches

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