Screening for coeliac disease in children

Kivelä, Laura; Kurppa, Kalle

doi:10.1111/apa.14468

Cited by 31 publications

(28 citation statements)

References 65 publications

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“…Thus, it can be associated with CD neurological diseases, osteoporosis, T-cell lymphoma, as well as other autoimmune diseases, such as type I diabetes, tiroiditis, and Addison's disease [5]. Recent studies demonstrate that this initially considered rare disease is relatively common, affecting around 1-3% of the general population in both Europe and North America [6][7][8]. The genetic component of CD is associated with specific class II Major Histocompatibility Complex (MHC) alleles.…”

Section: Introductionmentioning

confidence: 99%

Alterations in One-Carbon Metabolism in Celiac Disease

et al. 2020

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Celiac disease (CD) is an autoimmune enteropathy associated with alterations of metabolism. Metabolomics studies, although limited, showed changes in choline, choline-derived lipids, and methionine concentrations, which could be ascribed to alterations in one-carbon metabolism. To date, no targeted metabolomics analysis investigating differences in the plasma choline/methionine metabolome of CD subjects are reported. This work is a targeted metabolomic study that analyzes 37 metabolites of the one-carbon metabolism in 17 children with CD, treated with a gluten-free diet and 17 healthy control siblings, in order to establish the potential defects in this metabolic network. Our results demonstrate the persistence of defects in the transsulfuration pathway of CD subjects, despite dietary treatment, while choline metabolism, methionine cycle, and folate cycle seem to be reversed and preserved to healthy levels. These findings describe for the first time, a metabolic defect in one-carbon metabolism which could have profound implications in the physiopathology and treatment of CD.

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Section: Introductionmentioning

confidence: 99%

Alterations in One-Carbon Metabolism in Celiac Disease

et al. 2020

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“…Recently, the need to estimate the benefits and the economic aspects of CD screening was emphasised. 3 The aim of the present prospective study was to evaluate diag- Seventy tests showed no line. In this group, none had IgA deficiency and none was diagnosed as having CD (Figure 1).…”

mentioning

confidence: 98%

Point‐of‐Care test screening versus Case finding for paediatric coeliac disease: A pragmatic study in primary care

Primavera¹,

Aiello

Grosso

et al. 2020

Acta Paediatrica

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In paediatric coeliac disease (CD), symptoms may not be a reliable factor in the diagnosis of coeliac disease as described by Rosen et al, 1 and thus, recommendations for reviewing CD screening criteria were suggested. 2 Apart from the costs, an important limiting factor in paediatric population mass screening using conventional immunoglobulin (Ig) A tissue transglutaminase (tTGIgA) may be the low compliance of asymptomatic children to be referred for testing. On the other hand, the alternative approach, the CF strategy, relies on

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“…In addition, there is increased risk of autoimmune disorders related directly to duration of exposure to gluten in CD. 129 Evidence about the risks of long-term severe complications in unrecognised CD is controversial 130 with some reports suggesting that the risks of malignancy, bone demineralisation and infertility may be less than previously thought. 131 Regular follow-up is essential once diagnosis is established.…”

Section: Management and Follow Upmentioning

confidence: 99%

Coeliac disease in childhood: An overview

Bishop

Ravikumara

2020

J Paediatrics Child Health

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Coeliac disease (CD) is an autoimmune condition, characterised by an immunological response to ingestion of gluten in genetically susceptible individuals, affecting about 1% of the population in many regions of the world. Increased knowledge regarding the pathogenesis, improved diagnostic techniques and increased awareness over the years have transformed our understanding of CD such that it is no longer a rare enteropathy, but rather a common multisystem disorder which affects individuals of all ages and results in wide‐ranging clinical manifestations. Only a minority of children now present with the classical clinical picture of profound diarrhoea and malnutrition. An increasing number of children with CD present with either mild, non‐specific gastrointestinal symptoms or extra‐intestinal manifestations or even be asymptomatic, as in many screening‐detected children. Knowledge about these diverse manifestations and a high index of suspicion is essential so that appropriate investigations can be undertaken, diagnosis established and treatment initiated. Although traditionally small bowel biopsy is considered essential for the diagnosis, recent guidelines from various professional bodies have paved the way to a biopsy‐free diagnosis in a subset of symptomatic children. Life long, strict gluten‐free diet still remains the only effective treatment at present, although several novel therapeutic agents are in various phases of clinical trials.

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Screening for coeliac disease in children

Abstract: There is moderate evidence that screening certain at-risk groups for coeliac disease could be beneficial, but more studies in different settings are needed before large-scale population screening can be recommended.

Cited by 31 publications

References 65 publications

Alterations in One-Carbon Metabolism in Celiac Disease

Alterations in One-Carbon Metabolism in Celiac Disease

Point‐of‐Care test screening versus Case finding for paediatric coeliac disease: A pragmatic study in primary care

Coeliac disease in childhood: An overview

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