Outcome in pediatric celiac disease is independent of the diagnostic approach in patients with high antibody levels.

Klöti, Simon; Schaad, Joachim; Spalinger, Johannes; Schibli, Susanne; Hart, Lara; Sokollik, Christiane; Righini-Grunder, Franziska (2024). Outcome in pediatric celiac disease is independent of the diagnostic approach in patients with high antibody levels. (In Press). Journal of pediatric gastroenterology and nutrition Wolters Kluwer 10.1002/jpn3.12251

Text J_pediatr_gastroenterol_nutr_-_2024_-_Kl_ti_-_Outcome_in_pediatric_celiac_disease_is_independent_of_the_diagnostic.pdf - Published Version Restricted to registered users only Available under License Publisher holds Copyright. Download (662kB) | Request a copy

OBJECTIVES

European Society for Paediatric Gastroenterology, Hepatology and Nutrition guidelines enable the diagnosis of celiac disease (CD) without biopsies in patients with immunoglobulin A (IgA)-antibodies against tissue transglutaminase (TGA-IgA) ≥ 10× the upper limit of normal (ULN) and positivity of endomysial antibodies in a second blood sample. Limited data exist comparing the biopsy versus the nonbiopsy diagnostic approach regarding long-term outcomes in CD patients. Our study aimed to investigate the influence of the diagnostic approach on adherence to gluten-free diet (GFD), serological remission (defined as normalization of TGA-IgA during follow-up (FU)) and clinical remission in CD patients with TGA-IgA ≥ 10× ULN.

METHODS

Retrospective multicenter study. Patients with CD and TGA-IgA ≥ 10× ULN at diagnosis were included in the study. Patients with confirmed diagnosis by biopsy were compared to patients diagnosed by nonbiopsy approach using univariate analysis, Kaplan-Meier survival curve, and logistic regression models.

RESULTS

A total of 282 CD patients (192 [68.1%] in the biopsy group; 90 [31.9%] in the nonbiopsy group) were analyzed. The median time to normalization of TGA-IgA was 16.5 months [interquartile range, IQR: 13, 28] in the biopsy and 15 months [IQR: 12, 26] in the nonbiopsy group; p = 0.14). Rates of normalized TGA-IgA at first to third-year FU were comparable between both groups. Adherence to GFD did not seem to be influenced by the diagnostic approach.

CONCLUSIONS

The nonbiopsy approach is not inferior to the biopsy approach in terms of adherence to GFD and serological remission in patients with CD.

Interest & Impact

Downloads

0 since deposited on 22 May 2024
0 in the past 12 months

Citations

5 Citations in Web of Science ®
6 Citations in Scopus

Search

in Google Scholar™

Services

Actions (login required)

Edit item

Actions (login required)

Edit item