Transformative Impact of Mass Screening and Treatment for Celiac Disease in Children

Celiac.com 05/30/2024 - Celiac disease is a chronic autoimmune disorder triggered by gluten ingestion in genetically predisposed individuals. Despite its prevalence, celiac disease often goes undiagnosed or is diagnosed late due to varied symptoms or asymptomatic presentations. Mass screening for celiac disease remains a topic of debate within the medical community due to limited data supporting its benefits. The Autoimmunity Screening for Kids (ASK) study conducted in Colorado aimed to assess the impact of mass screening for pediatric celiac disease and type 1 diabetes.

Study Overview

The ASK study prospectively followed children aged 1-17 years who tested positive for tissue transglutaminase IgA autoantibodies (tTGA) through mass screening. Those subsequently diagnosed with celiac disease via biopsy or serologic criteria were included in this analysis. The study evaluated various parameters at baseline and 12-month follow-up, including demographics, laboratory studies, symptoms, health-related quality of life (HRQoL), anxiety/depression, and adherence to a gluten-free diet.

Key Findings

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The study included 52 children with  celiac disease , of whom 42 completed the 12-month follow-up. At baseline, most children reported one or more symptoms related to  celiac disease. Over the follow-up period, there was a significant improvement in mean symptom severity and frequency scores, indicating better symptom management with treatment.

Health-related quality of life scores among caregivers also showed improvement, highlighting the broader impact of celiac disease diagnosis and treatment on family dynamics. Interestingly, there was no significant change in reported anxiety or depression, suggesting that celiac disease treatment did not exacerbate mental health issues in this cohort.

Iron deficiency without anemia was prevalent at baseline but normalized in a significant portion of children at follow-up, indicating the positive impact of celiac disease treatment on nutritional status. Moreover, families reported good to excellent adherence to the gluten-free diet, crucial for managing celiac disease effectively.

Conclusion

In conclusion, the ASK study demonstrated that mass screening and subsequent treatment of celiac disease in children led to notable improvements in symptoms, quality of life, and nutritional status. These findings underscore the potential benefits of celiac disease mass screening programs, especially in identifying undiagnosed cases and improving health outcomes with timely intervention. Further research is needed to determine the cost-effectiveness of mass screening and its comparative efficacy against targeted screening approaches.

Read more at: cghjournal.org