Diagnosis of celiac disease and applicability of ESPGHAN guidelines in Mediterranean countries: a real life prospective study.

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dc.contributor.authorKansu Tanca, Aydan
dc.contributor.departmentTıp Fakültesitr_TR
dc.date.accessioned2020-04-01T11:13:07Z
dc.date.available2020-04-01T11:13:07Z
dc.date.issued2017-01
dc.description.abstractBackground: We assessed how the diagnosis of Celiac Disease (CD) is made and how the new ESPGHAN guidelines can be applied in children from countries with different resources. Methods: A real life prospective study was performed in 14 centres of 13 different Mediterranean countries. Participants were asked to apply the usual diagnostic work-up for CD according to their diagnostic facilities. Results: There were 1974 patients enrolled in the study, mean age 4 years, 10 months; 865 male, 1109 female. CD was confirmed in 511 (25.9%) and was unconfirmed in 1391 (70.5%) patients; 14 patients were diagnosed as having CD according to the new ESPGHAN guidelines, 43 patients were classified as having potential CD. In all participating countries the diagnosis of CD relied on histology of duodenal biopsy; in 5 countries, HLA, and in one country endomysial antibodies (EMA) were not available. Symptoms did not add a significant increase to the pre-test probability of serological tests. The positive predictive value of tissue transglutaminase type 2 (tTG) antibodies performed with different kits but all corresponding to those recommended by ESPGHAN was 96.1% (95% CI 94–97.9%) in presence of tTG > 10xULN. In 135 patients with tTG >10xULN, HLA genotyping was performed and in all it was compatible with CD. Conclusions: The results of our study show that CD diagnosis still relies on intestinal biopsy in the Mediterranean area. New ESPGHAN criteria are not applicable in 5 countries due to lack of resources needed to perform HLA genotyping and, in one country, EMA assay. Further simplification of the new ESPGHAN guidelines might be made according to what preliminarily the present results suggest if confirmed by new prospective studiestr_TR
dc.identifier.endpage8tr_TR
dc.identifier.issue17tr_TR
dc.identifier.startpage1tr_TR
dc.identifier.urihttps://doi.org/10.1186/s12876-017-0577-xtr_TR
dc.identifier.urihttp://hdl.handle.net/20.500.12575/70861
dc.identifier.volume17tr_TR
dc.language.isoentr_TR
dc.relation.isversionof10.1186/s12876-017-0577-xtr_TR
dc.relation.journalBMC Gastroenteroltr_TR
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Başka Kurum Yazarıtr_TR
dc.subjectCeliac disease, Diagnosis, Mediterranean area, ESPGHANtr_TR
dc.titleDiagnosis of celiac disease and applicability of ESPGHAN guidelines in Mediterranean countries: a real life prospective study.tr_TR
dc.typeArticletr_TR

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