Jump to content
This site uses cookies. Continued use is acceptance of our Terms of Use and Privacy Policy. More Info... ×
  • Welcome to Celiac.com!

    You have found your celiac tribe! Join us and ask questions in our forum, share your story, and connect with others.




  • Celiac.com Sponsor (A1):



    Celiac.com Sponsor (A1-M):


  • Get Celiac.com Updates:
    Support Our Content
    eNewsletter
    Donate
  • Scott Adams
    Scott Adams

    Biopsies Unnecessary for Celiac Diagnosis in Most Children

    Reviewed and edited by a celiac disease expert.

    European study confirms the reliability of diagnosing celiac disease without upper endoscopy in children and teens who meet set criteria. 

    Biopsies Unnecessary for Celiac Diagnosis in Most Children - Kids no longer need a biopsy to diagnose their CD. Image: CC BY 2.0--Pakus Futuro Bloguero
    Caption: Kids no longer need a biopsy to diagnose their CD. Image: CC BY 2.0--Pakus Futuro Bloguero

    Celiac.com 04/13/2020 - Current guidelines set by the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN), permit doctors to diagnose celiac disease without upper endoscopy in children and adolescents who meet specific criteria. 

    A team of researchers recently set out to to assess exactly how many pediatric gastroenterologists in Central Europe used the “no-biopsy” approach to make a celiac diagnosis, and how many biopsies could have been avoided. 

    Celiac.com Sponsor (A12):
    The research team included Petra Riznik, Márta Balogh, Piroska Bódi, Luigina De Leo, Jasmina Dolinsek, Ildikó Guthy, Judit Gyimesi, Ágnes Horváth, Ildikó Kis, Martina Klemenak, Berthold Koletzko,0, Sibylle Koletzko,, Ilma Rita Korponay-Szabó,, Tomaz Krencnik, Tarcisio Not, Goran Palcevski, Éva Pollák, Daniele Sblattero, István Tokodi, Matej Vogrincic, Katharina Julia Werkstetter, and Jernej Dolinsek.

    The team analyzed 2016 medical records for celiac patients under 19 years old, who were diagnosed in five European countries. They concentrated on transglutaminase antibody (TGA) levels at diagnosis, and on whether celiac diagnosis was confirmed with or without duodenal biopsy. Using diagnostic guidelines, they also noted clinical presentation and any delays in the final diagnosis.

    The gathered data from 653 children from Croatia, Hungary, Germany, Italy, and Slovenia. Subjects ranged in age from 7 months-18.5 years, with an average patient age of 7 years. Just under 64% were female,

    A total of 134 children were asymptomatic at diagnosis. Of 519 children who did show symptoms, 107, nearly 21%, were diagnosed without biopsy. Out of 412 children diagnosed via biopsy, 214, or nearly 52% had TGA at or above 10 times upper level of normal (ULN) and thus could have been diagnosed without biopsy. Signs and symptoms of malabsorption were more frequent in children diagnosed without duodenal biopsies.

    The data showed no differences in diagnostic times with the no-biopsy approach. In this study, about 60% of celiac patients who show symptoms could have been diagnosed without duodenal biopsies. However, only 20% of eligible patients are getting a biopsy-free celiac diagnosis.

    The research team recommends educating doctors about the ease and reliability of biopsy-free celiac diagnosis as part of the ESPGHAN guidelines.

    Read more in Hindawi
     

    The researchers are variously affiliated with the University Medical Centre Maribor, Department of Paediatrics, Gastroenterology, Hepatology and Nutrition Unit, Maribor, Slovenia; Markusovszky Teaching Hospital, Szombathely, Hungary, Pándy Kálmán Hospital, Gyula, Hungary; IRCCS Burlo Garofolo Trieste, Institute for Maternal and Child Health, Trieste, Italy; Municipality of Maribor, Project Office, Maribor, Slovenia; Jósa András County Hospital, Nyíregyháza, Hungary; Heim Pál National Paediatric Institute, Coeliac Disease Centre, Budapest, Hungary; Csolnoky Ferenc County Hospital, Veszprém, Hungary; St. Barbara County Hospital, Tatabánya, Hungary; Stiftung Kindergesundheit (Child Health Foundation) at Dr. von Hauner Children’s Hospital, LMU Munich, Munich, Germany; Dr. von Hauner Children’s Hospital, Clinical Medical Centre, LMU Munich, Munich, Germany; Department of Pediatrics, Gastroenterology and Nutrition, School of Medicine Collegium Medicum University of Warmia and Mazury, Olsztyn, Poland; University of Debrecen, Faculty of Medicine, Department of Paediatrics, Debrecen, Hungary; University Hospital Rijeka, Department for Gastroenterology, Paediatric Clinic, Rijeka, Croatia; Ajka County Hospital, Ajka, Hungary; University of Trieste, Trieste, Italy; St. George Fejér County University Teaching Hospital, Székesfehérvár, Hungary; University Medical Centre Maribor, Department of Informatics, Maribor, Slovenia; and the Medical Faculty, Department of Paediatrics, University of Maribor, Maribor, Slovenia.

    Edited by Scott Adams



    User Feedback

    Recommended Comments

    There are no comments to display.



    Create an account or sign in to comment

    You need to be a member in order to leave a comment

    Create an account

    Sign up for a new account in our community. It's easy!

    Register a new account

    Sign in

    Already have an account? Sign in here.

    Sign In Now

  • Get Celiac.com Updates:
    Support Celiac.com:
    Donate
  • About Me

    Scott Adams

    Scott Adams was diagnosed with celiac disease in 1994, and, due to the nearly total lack of information available at that time, was forced to become an expert on the disease in order to recover. In 1995 he launched the site that later became Celiac.com to help as many people as possible with celiac disease get diagnosed so they can begin to live happy, healthy gluten-free lives.  He is co-author of the book Cereal Killers, and founder and publisher of the (formerly paper) newsletter Journal of Gluten Sensitivity. In 1998 he founded The Gluten-Free Mall which he sold in 2014. Celiac.com does not sell any products, and is 100% advertiser supported.


  • Celiac.com Sponsor (A17):
    Celiac.com Sponsor (A17):





    Celiac.com Sponsors (A17-M):




  • Related Articles

    Jefferson Adams
    Can Doctors Diagnose Celiac Disease in Kids Without Biopsy?
    Celiac.com 03/09/2016 - Can doctors reliably diagnose celiac disease in kids without duodenal biopsy?
    A team of researchers recently set out to see if they could use predictive values of transglutaminase (tTG) antibodies to diagnose celiac disease in kids, without performing duodenal biopsy.
    The research team included MA Aldaghi, SM Dehghani, and M Haghighat, of the Department of Pediatrics at Shiraz University of Medical Sciences in Shiraz, Iran.
    For their study, the team selected patients with likely celiac disease, who had been referred to a gastrointestinal clinic. The team first conducted physical examinations of the patients and performed tissue transglutaminase-immunoglobulin A (tTG-IgA) tests. For patients with serological titers higher than 18 IU/mL, the t...


    Jefferson Adams
    Celiac.com 05/19/2016 - Using a prospective cohort study, a team of researchers recently set out to assess the outcomes of the latest celiac diagnosis guidelines from the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN).
    The research team included Elisa Benelli, Valentina Carrato, Stefano Martelossi, Luca Ronfani, Tarcisio Not, and Alessandro Ventura. They are variously affiliated with the Department of Medical, Surgical and Health Sciences, University of Trieste in Trieste, Italy, and the Institute for Maternal and Child Health IRCCS 'Burlo Garofolo' in Trieste, Italy. The study was conducted at the Institute for Maternal and Child Health IRCCS Burlo Garofolo in Trieste...


    Jefferson Adams
    Can Antibodies Spot Celiac Disease in Kids Without a Biopsy?
    Celiac.com 06/05/2017 - Doctors diagnose celiac disease by confirming various clinical, genetic, serologic, and duodenal morphology features. Based on retrospective data, recent pediatric guidelines propose eliminating biopsy for patients with IgA-TTG levels more than 10-times the upper limit of normal (ULN), along with a few other criteria.
    One retrospective study showed that researchers using levels of IgA-TTG and total IgA, or IgA-TTG and IgG against deamidated gliadin (IgG-DGL) could identify patients both with and without celiac disease. A team of researchers recently set out to validate the positive and negative predictive values (PPV and NPV) of these diagnostic procedures.
    The research team included Johannes Wolf, David Petroff, Thomas Richter, Marcus KH. Auth, Holm H. Uhlig...


    Jefferson Adams
    No More Biopsies to Diagnose Celiac Disease in Children!
    Celiac.com 03/02/2020 - Current practice of using biopsy to diagnose children with celiac disease is changing to diagnosis without biopsy. 
    The European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) recently issued new guidelines that recommend doctors diagnosing celiac disease omit biopsy in favor of a two-stage blood test, for the majority of children suspected of having the disease.
    New guidelines for diagnosing celiac disease in children call for avoiding biopsies in favor of a two-stage blood test. Until now, about half of all kids diagnosed with celiac disease got a biopsy. The new guidelines mean that nearly all kids will avoid the procedure in favor of a two-stage blood test.
    The new guidelines recommend that doctors:
    Conduct ...


  • Recent Activity

    1. - cristiana replied to Mary Em's topic in Related Issues & Disorders
      5

      Passing out

    2. - Wheatwacked replied to Mary Em's topic in Related Issues & Disorders
      5

      Passing out

    3. - ElisaL replied to Mary Em's topic in Related Issues & Disorders
      5

      Passing out

    4. - jmiller93 replied to jmiller93's topic in Celiac Disease Pre-Diagnosis, Testing & Symptoms
      6

      What do my test results mean?

    5. - knitty kitty replied to jmiller93's topic in Celiac Disease Pre-Diagnosis, Testing & Symptoms
      6

      What do my test results mean?


  • Celiac.com Sponsor (A19):



  • Member Statistics

    • Total Members
      125,736
    • Most Online (within 30 mins)
      7,748

    Haycin
    Newest Member
    Haycin
    Joined

  • Celiac.com Sponsor (A20):


  • Forum Statistics

    • Total Topics
      120.8k
    • Total Posts
      1m

  • Celiac.com Sponsor (A22):





  • Celiac.com Sponsor (A21):



  • Popular Now

    • jmiller93
      6
    • MomofGF
    • Louise Broughton
      4
  • Popular Articles

    • Scott Adams
    • Scott Adams
    • Scott Adams
    • Scott Adams
    • Scott Adams
  • Upcoming Events

×
×
  • Create New...