The Use of Biopsy and “No-Biopsy” Approach for Diagnosing Paediatric Coeliac Disease in the Central European Region
Objectives. The current European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) guidelines introduced the option to diagnose coeliac disease (CD) in children and adolescents without upper endoscopy if the defined criteria are met. The aim of our study was to evaluate ho...
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Wiley
2019-01-01
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| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2019/9370397 |
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| author | Petra Riznik Márta Balogh Piroska Bódi Luigina De Leo Jasmina Dolinsek Ildikó Guthy Judit Gyimesi Ágnes Horváth Ildikó Kis Martina Klemenak Berthold Koletzko Sibylle Koletzko Ilma Rita Korponay-Szabó Tomaz Krencnik Tarcisio Not Goran Palcevski Éva Pollák Daniele Sblattero István Tokodi Matej Vogrincic Katharina Julia Werkstetter Jernej Dolinsek |
| author_facet | Petra Riznik Márta Balogh Piroska Bódi Luigina De Leo Jasmina Dolinsek Ildikó Guthy Judit Gyimesi Ágnes Horváth Ildikó Kis Martina Klemenak Berthold Koletzko Sibylle Koletzko Ilma Rita Korponay-Szabó Tomaz Krencnik Tarcisio Not Goran Palcevski Éva Pollák Daniele Sblattero István Tokodi Matej Vogrincic Katharina Julia Werkstetter Jernej Dolinsek |
| author_sort | Petra Riznik |
| collection | DOAJ |
| description | Objectives. The current European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) guidelines introduced the option to diagnose coeliac disease (CD) in children and adolescents without upper endoscopy if the defined criteria are met. The aim of our study was to evaluate how frequently paediatric gastroenterologists in Central Europe used the “no-biopsy” approach and how often the duodenal biopsy could have been omitted. Methods. Medical records of patients aged<19 years diagnosed with CD in 2016 from five European countries were analysed, focusing on levels of transglutaminase antibodies (TGA) at the time of diagnosis and on whether the diagnosis was confirmed using duodenal biopsy or “no-biopsy” approach. Clinical presentation and delays until final diagnosis were analysed according to diagnostic approach. Results. Data from 653 children (63.9% female, median age: 7 years, range: 7 months-18.5 years) from Croatia, Hungary, Germany, Italy, and Slovenia were analysed. One fifth (n=134) of included children were asymptomatic at diagnosis. Of 519 symptomatic children, 107 (20.6%) were diagnosed by the “no-biopsy” approach. Out of the remaining 412 children who underwent duodenal biopsies, 214 (51.9%) had TGA≥10 times upper level of normal (ULN) and would have been eligible for the “no-biopsy” approach. Signs and symptoms of malabsorption were more frequent in children diagnosed without duodenal biopsies. There were no differences in diagnostic delays with respect to the diagnostic approach. Conclusion. In this cohort, about 60% of symptomatic CD patients could have been diagnosed without duodenal biopsies. The aim of the “no-biopsy” approach was to make the diagnostic procedure less challenging without compromising its reliability. However, this option was applied only in 20%, in spite of fewer burdens to the family and reduced costs. The reasons for this discrepancy are unknown. Physicians should be made more aware about the reliability of CD diagnosis without biopsies when the ESPGHAN guidelines for CD diagnosis are followed. |
| format | Article |
| id | doaj-art-9cc7b41a7d594aa983f75feecf99ee37 |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-9cc7b41a7d594aa983f75feecf99ee372025-02-03T05:59:32ZengWileyGastroenterology Research and Practice1687-61211687-630X2019-01-01201910.1155/2019/93703979370397The Use of Biopsy and “No-Biopsy” Approach for Diagnosing Paediatric Coeliac Disease in the Central European RegionPetra Riznik0Márta Balogh1Piroska Bódi2Luigina De Leo3Jasmina Dolinsek4Ildikó Guthy5Judit Gyimesi6Ágnes Horváth7Ildikó Kis8Martina Klemenak9Berthold Koletzko10Sibylle Koletzko11Ilma Rita Korponay-Szabó12Tomaz Krencnik13Tarcisio Not14Goran Palcevski15Éva Pollák16Daniele Sblattero17István Tokodi18Matej Vogrincic19Katharina Julia Werkstetter20Jernej Dolinsek21University Medical Centre Maribor, Department of Paediatrics, Gastroenterology, Hepatology and Nutrition Unit, Maribor, SloveniaMarkusovszky Teaching Hospital, Szombathely, HungaryPándy Kálmán Hospital, Gyula, HungaryIRCCS Burlo Garofolo Trieste, Institute for Maternal and Child Health, Trieste, ItalyMunicipality of Maribor, Project Office, Maribor, SloveniaJósa András County Hospital, Nyíregyháza, HungaryHeim Pál National Paediatric Institute, Coeliac Disease Centre, Budapest, HungaryCsolnoky Ferenc County Hospital, Veszprém, HungarySt. Barbara County Hospital, Tatabánya, HungaryUniversity Medical Centre Maribor, Department of Paediatrics, Gastroenterology, Hepatology and Nutrition Unit, Maribor, SloveniaStiftung Kindergesundheit (Child Health Foundation) at Dr. von Hauner Children’s Hospital, LMU Munich, Munich, GermanyDr. von Hauner Children’s Hospital, Clinical Medical Centre, LMU Munich, Munich, GermanyHeim Pál National Paediatric Institute, Coeliac Disease Centre, Budapest, HungaryUniversity Medical Centre Maribor, Department of Paediatrics, Gastroenterology, Hepatology and Nutrition Unit, Maribor, SloveniaIRCCS Burlo Garofolo Trieste, Institute for Maternal and Child Health, Trieste, ItalyUniversity Hospital Rijeka, Department for Gastroenterology, Paediatric Clinic, Rijeka, CroatiaAjka County Hospital, Ajka, HungaryUniversity of Trieste, Trieste, ItalySt. George Fejér County University Teaching Hospital, Székesfehérvár, HungaryUniversity Medical Centre Maribor, Department of Informatics, Maribor, SloveniaDr. von Hauner Children’s Hospital, Clinical Medical Centre, LMU Munich, Munich, GermanyUniversity Medical Centre Maribor, Department of Paediatrics, Gastroenterology, Hepatology and Nutrition Unit, Maribor, SloveniaObjectives. The current European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) guidelines introduced the option to diagnose coeliac disease (CD) in children and adolescents without upper endoscopy if the defined criteria are met. The aim of our study was to evaluate how frequently paediatric gastroenterologists in Central Europe used the “no-biopsy” approach and how often the duodenal biopsy could have been omitted. Methods. Medical records of patients aged<19 years diagnosed with CD in 2016 from five European countries were analysed, focusing on levels of transglutaminase antibodies (TGA) at the time of diagnosis and on whether the diagnosis was confirmed using duodenal biopsy or “no-biopsy” approach. Clinical presentation and delays until final diagnosis were analysed according to diagnostic approach. Results. Data from 653 children (63.9% female, median age: 7 years, range: 7 months-18.5 years) from Croatia, Hungary, Germany, Italy, and Slovenia were analysed. One fifth (n=134) of included children were asymptomatic at diagnosis. Of 519 symptomatic children, 107 (20.6%) were diagnosed by the “no-biopsy” approach. Out of the remaining 412 children who underwent duodenal biopsies, 214 (51.9%) had TGA≥10 times upper level of normal (ULN) and would have been eligible for the “no-biopsy” approach. Signs and symptoms of malabsorption were more frequent in children diagnosed without duodenal biopsies. There were no differences in diagnostic delays with respect to the diagnostic approach. Conclusion. In this cohort, about 60% of symptomatic CD patients could have been diagnosed without duodenal biopsies. The aim of the “no-biopsy” approach was to make the diagnostic procedure less challenging without compromising its reliability. However, this option was applied only in 20%, in spite of fewer burdens to the family and reduced costs. The reasons for this discrepancy are unknown. Physicians should be made more aware about the reliability of CD diagnosis without biopsies when the ESPGHAN guidelines for CD diagnosis are followed.http://dx.doi.org/10.1155/2019/9370397 |
| spellingShingle | Petra Riznik Márta Balogh Piroska Bódi Luigina De Leo Jasmina Dolinsek Ildikó Guthy Judit Gyimesi Ágnes Horváth Ildikó Kis Martina Klemenak Berthold Koletzko Sibylle Koletzko Ilma Rita Korponay-Szabó Tomaz Krencnik Tarcisio Not Goran Palcevski Éva Pollák Daniele Sblattero István Tokodi Matej Vogrincic Katharina Julia Werkstetter Jernej Dolinsek The Use of Biopsy and “No-Biopsy” Approach for Diagnosing Paediatric Coeliac Disease in the Central European Region Gastroenterology Research and Practice |
| title | The Use of Biopsy and “No-Biopsy” Approach for Diagnosing Paediatric Coeliac Disease in the Central European Region |
| title_full | The Use of Biopsy and “No-Biopsy” Approach for Diagnosing Paediatric Coeliac Disease in the Central European Region |
| title_fullStr | The Use of Biopsy and “No-Biopsy” Approach for Diagnosing Paediatric Coeliac Disease in the Central European Region |
| title_full_unstemmed | The Use of Biopsy and “No-Biopsy” Approach for Diagnosing Paediatric Coeliac Disease in the Central European Region |
| title_short | The Use of Biopsy and “No-Biopsy” Approach for Diagnosing Paediatric Coeliac Disease in the Central European Region |
| title_sort | use of biopsy and no biopsy approach for diagnosing paediatric coeliac disease in the central european region |
| url | http://dx.doi.org/10.1155/2019/9370397 |
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