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Description
  • The aim of this study was to assess the accuracy of serological tests in combination with clinical symptoms for diagnosing celiac disease (CD) according to the new proposed European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) criteria. We retrospectively assessed children and adolescents aged 16 months -19 years who were examined for suspicion of CD (n = 345). Evaluation of clinical symptoms and the presence of tissue transglutaminase (anti-TG-IgA) and endomysial antibodies (EMA-IgA) as well as intestinal biopsies was performed in all patients. Human leukocyte antigens (HLAs) were not included. Among 345 biopsied children, 213 (62 %) children had anti-TG titers >10 times the upper limit of normal (ULN) and positive EMA antibodies. Ninety-nine (29 %) children also had symptoms suggestive of CD in addition to EMA positivity and elevated titers of anti-TG >10 times the ULN. In patients who were asymptomatic, but positive for EMA, and had anti-TG antibodies >10 times the ULN, the specificity of tests for Marsh 2-3 was only 85 %, while in symptomatic patients with the same antibodies levels, the specificity was 99 %. Conclusion: Our results reveal that intestinal biopsies could be omitted in 28 % of patients when the new ESPGHAN guidelines are applied. Due to high accuracy of serological tests in combination with clinical symptoms for diagnosis of CD, the new guideline seems to be applicable even without the use of HLA testing.
  • The aim of this study was to assess the accuracy of serological tests in combination with clinical symptoms for diagnosing celiac disease (CD) according to the new proposed European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) criteria. We retrospectively assessed children and adolescents aged 16 months -19 years who were examined for suspicion of CD (n = 345). Evaluation of clinical symptoms and the presence of tissue transglutaminase (anti-TG-IgA) and endomysial antibodies (EMA-IgA) as well as intestinal biopsies was performed in all patients. Human leukocyte antigens (HLAs) were not included. Among 345 biopsied children, 213 (62 %) children had anti-TG titers >10 times the upper limit of normal (ULN) and positive EMA antibodies. Ninety-nine (29 %) children also had symptoms suggestive of CD in addition to EMA positivity and elevated titers of anti-TG >10 times the ULN. In patients who were asymptomatic, but positive for EMA, and had anti-TG antibodies >10 times the ULN, the specificity of tests for Marsh 2-3 was only 85 %, while in symptomatic patients with the same antibodies levels, the specificity was 99 %. Conclusion: Our results reveal that intestinal biopsies could be omitted in 28 % of patients when the new ESPGHAN guidelines are applied. Due to high accuracy of serological tests in combination with clinical symptoms for diagnosis of CD, the new guideline seems to be applicable even without the use of HLA testing. (en)
Title
  • Symptom positivity is essential for omitting biopsy in children with suspected celiac disease according to the new ESPGHAN guidelines
  • Symptom positivity is essential for omitting biopsy in children with suspected celiac disease according to the new ESPGHAN guidelines (en)
skos:prefLabel
  • Symptom positivity is essential for omitting biopsy in children with suspected celiac disease according to the new ESPGHAN guidelines
  • Symptom positivity is essential for omitting biopsy in children with suspected celiac disease according to the new ESPGHAN guidelines (en)
skos:notation
  • RIV/00216208:11130/14:10210582!RIV15-MSM-11130___
http://linked.open...avai/riv/aktivita
http://linked.open...avai/riv/aktivity
  • I
http://linked.open...iv/cisloPeriodika
  • 4
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  • 48890
http://linked.open...ai/riv/idVysledku
  • RIV/00216208:11130/14:10210582
http://linked.open...riv/jazykVysledku
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  • Children; Diagnosis; Guidelines; Celiac disease (en)
http://linked.open.../riv/klicoveSlovo
http://linked.open...odStatuVydavatele
  • GB - Spojené království Velké Británie a Severního Irska
http://linked.open...ontrolniKodProRIV
  • [C3A7A2AA0340]
http://linked.open...i/riv/nazevZdroje
  • European Journal of Pediatrics
http://linked.open...in/vavai/riv/obor
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http://linked.open...UplatneniVysledku
http://linked.open...v/svazekPeriodika
  • 173
http://linked.open...iv/tvurceVysledku
  • Bronský, Jiří
  • Nevoral, Jiří
  • Lašťovička, Jan
  • Trnková, M.
  • Kotalová, Radana
  • Hradský, Ondřej
  • Zárubová, Kristýna
  • Neubertová, E.
  • Valtrová, Věra
http://linked.open...ain/vavai/riv/wos
  • 000332964600013
issn
  • 1432-1076
number of pages
http://bibframe.org/vocab/doi
  • 10.1007/s00431-013-2215-0
http://localhost/t...ganizacniJednotka
  • 11130
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