Coeliac disease diagnosis: ESPGHAN 1990 criteria or need for a change? Results of a questionnaire

C. Ribes-Koninckx, Ml Mearin, Ir Korponay-Szabó, R. Shamir, S. Husby, A. Ventura, D. Branski, C. Catassi, S. Koletzko, M. Mäki, R. Troncone, Kp Zimmer

Research output: Contribution to journalArticlepeer-review

Abstract

Background and Objectives: A revision of criteria for diagnosing coeliac disease (CD) is being conducted by The European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN). In parallel, we have performed a survey aimed to evaluate present practices for CD among paediatric gastroenterologists and to learn their views on the need for modification of present criteria for CD diagnosis. Patients and Methods: Questionnaires were distributed to experienced paediatric gastroenterologists (ESPGHAN members) via the Internet. Results: Overall, 95 valid questionnaires were available for analysis, pertaining to 28 different countries, with the majority of responders treating patients with CD for >15 years. Only about 12% of the responders comply with present criteria, noncompliance being related mainly to the challenge policy. Approximately 90% request a revision and modification of the present criteria. Forty-four percent want to omit the small bowel biopsy in symptomatic children with positive anti-tissue transglutaminase immunoglobulin (Ig) A or endomysial IgA antibodies, especially if they are DQ2/DQ8 positive. For silent cases detected by screening with convincingly positive anti-tissue transglutaminase IgA or EMA IgA, about 30% consider that no small bowel biopsy should be required in selected cases. Adding human leukocyte antigen typing in the diagnostic workup was asked for by 42% of the responders. As for gluten challenge, a new policy is advocated restricting its obligation to cases whenever the diagnosis is doubtful or unclear. Conclusions: Based on these opinions, revision of the ESPGHAN criteria for diagnosing CD is urgently needed.

Original languageEnglish
Pages (from-to)15-19
Number of pages5
JournalJournal of Pediatric Gastroenterology and Nutrition
Volume54
Issue number1
DOIs
StatePublished - Jan 2012

Keywords

  • coeliac disease diagnosis
  • ESPGHAN 1990 criteria
  • questionnaire

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