Role of Serology, Dietary Assessment, and Fecal Gluten Immunogenic Peptides for Predicting Histologic Recovery in Children with Celiac Disease

Seetharaman, Keerthivasan; Lal, Sadhna; Prasad, Kaushal Kishor; Kumar, Yashwant; Bhatia, Alka; Malhotra, Sunita

doi:10.1007/s10620-022-07762-8

Cited by 5 publications

(2 citation statements)

References 37 publications

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“…As expected, TG-IgA levels at interview were directly associated with a biopsy-sparing diagnosis, as this mode of diagnosis is only allowed in the presence of TGA-IgA > 10 × ULN, a shorter disease duration, and higher levels at diagnosis. No relationship was found with adherence scores, suggesting that TGA-IgA is not an ideal tool, not only for assessing histologic recovery [11,12], but also for discriminating between strictly and poorly compliant patients [13].…”

Section: Discussionmentioning

confidence: 94%

“…The assessment of duodenal biopsies, which is considered the gold standard, is not feasible for routine CD follow-up in every case, due to these biopsies' invasiveness, relative risk, and high cost, especially in children. Gastroenterologists frequently use a combination of self-and parent-reported adherence, the presence of symptoms, dietary assessment by a trained dietitian, and biomarkers (both in the blood and in urine/stool samples), even though it is accepted that these methods are limited for accurately detecting gluten transgressions and histologic recovery [9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

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Determinants of Adherence to a Gluten-Free Diet in Children with Celiac Disease and the Influence of the Methods Used to Assess It

Monzani,

Marcolin,

Giorda

et al. 2023

Nutrients

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Lifelong adherence to a gluten-free diet (GFD) is the cornerstone of management of celiac disease (CD), but adhering to a GFD can be hard. Although several factors are positively associated with adherence of pediatric CD patients to a GFD, it is unknown whether these are influenced by variability caused by the specific tool used to assess adherence to a GFD. Here, we aimed to evaluate how individual patient characteristics and dietary counselling by a trained dietitian influence adherence to a GFD in children with CD, as assessed by two validated questionnaires: the Biagi questionnaire and the Leffler short questionnaire adapted for pediatric patients. Some 139 children and adolescents were recruited in a cross-sectional, multicenter study. Concordance between the two questionnaires in defining adherence was fair (weighted Cohen’s kappa coefficient 0.39, 95%CI 0.19–0.60). Upon regression analysis, having a cohabiting family member with CD, being of Italian origin, and receiving specialized dietary counselling during follow-up were found to positively influence stricter adherence to a GFD for children with CD. Neither questionnaire detected a significant relationship between adherence to a GFD and the presence of symptoms after gluten ingestion. This study provides important new data on the factors influencing GFD adherence in the pediatric population, and highlights the importance of dietician input and overcoming language and cultural barriers when educating patients.

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Section: Discussionmentioning

confidence: 94%