Joint BSPGHAN and Coeliac UK guidelines for the diagnosis and management of coeliac disease in children

  title={Joint BSPGHAN and Coeliac UK guidelines for the diagnosis and management of coeliac disease in children},
  author={Simon H. Murch and Huw R. Jenkins and Marcus Karl-Heinz Auth and Ronald Bremner and Assad M. Butt and Stephanie France and M. A. Furman and Peter M Gillett and Fevronia Kiparissi and Maureen Lawson and Bruce McLain and Mary-Anne Morris and Sarah Sleet and Matthew Thorpe},
  journal={Archives of Disease in Childhood},
  pages={806 - 811}
The revised BSPGHAN guidelines for the diagnosis and management of coeliac disease represent an important shift in diagnostic strategy, aimed at simplifying and shortening the diagnostic process in selected cases. Guidance is given concerning the indications for testing for coeliac disease, which is still significantly underdiagnosed in the UK. While screening data suggest a likely incidence of 1 in 100 persons, only 10%–20% of this figure is currently being diagnosed.The BSPGHAN guidelines… 
Diagnosis and management of coeliac disease in children.
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The modified ESPGHAN guidelines recommend that in symptomatic children with anti-tissue-Transglutaminase (tTG) titre of > 10 times Upper-Limit-of-Normal (ULN), diagnosis of CD can be made without small-bowel biopsies, however, positive HLA-DQ2/DQ8 serotype and anti-Endomysial Antibodies are necessary.
Diagnosis of coeliac disease in children in primary care and clinical implications.
  • S. MurchR. StevensS. Sleet
  • Medicine
    The British journal of general practice : the journal of the Royal College of General Practitioners
  • 2014
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Children and young people with coeliac disease present with unique challenges for the health-care team, but with appropriate, targeted management and support, patients can meet their potential.
An Overview of International Guidelines Focusing on the Long-Term Management of Coeliac Disease
All available guidelines recommend strict adherence to a GFD with most recommending an annual review by a specialist clinician, focusing on symptoms, adherence and growth, and some suggest monitoring bone mineral density in at-risk groups and screening for other autoimmune disorders.
Management of coeliac disease patients after the confirmation of diagnosis in Central Europe.
Assessment of the management practices and experience of coeliac disease patients with their follow-up appointments in Central Europe found that many patients are not followed regularly and a lot are not referred to a dietitian.
Accuracy of potential diagnostic indicators for coeliac disease: a systematic review protocol
A systematic review to determine the accuracy of diagnostic indicators for CD in adults and children, and thus can help identify patients who should be offered CD testing and discuss findings with Coeliac UK to help with dissemination to patients.


Diagnosing coeliac disease
Diagnostic criteria for coeliac disease have not been revisited for 20 years, and it has become clear that CD may present with a large variety of non-specific signs and symptoms, rather than a specific gastrointestinal presentation.
Childhood coeliac disease diagnoses in Scotland 2009–2010: the SPSU project
Almost double the incidence of paediatric CD was observed in the East of Scotland, and evidence of more actively screened cases diagnosed and more antibody tests performed in the region suggests a lower threshold to test.
Coeliac disease
The Marsh classification of intestinal coeliac lesions, as modified by Oberhuber et al, is used by most pathologists to evaluate the intestinal lesions of patients with CD, both for diagnosis and to assess the regression of the lesions after a gluten free diet.
The histopathology of coeliac disease: time for a standardized report scheme for pathologists.
The most important histological differential diagnoses are given, as well as a definition of the different clinical forms of coeliac disease such as symptomatic, silent, latent, potential, treated and refractory coeliasis.
Guideline for the diagnosis and treatment of celiac disease in children: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition.
It is recommended that children and adolescents with symptoms of celiac disease or an increased risk for Celiac disease have a blood test for antibody to tissue transglutaminase (TTG), and that those with an elevated TTG be referred to a pediatric gastroenterologist for an intestinal biopsy and treated with a strict gluten-free diet.
The Oslo definitions for coeliac disease and related terms
A multidisciplinary task force of 16 physicians from seven countries used the electronic database PubMed to review the literature for CD-related terms and suggested a definition for each term, followed by feedback through a web survey on definitions and discussions during a meeting in Oslo.
Long-term follow-up of 61 coeliac patients diagnosed in childhood: evolution toward latency is possible on a normal diet
Long-term latency developed in about 20% of CD patients who remained symptom free after gluten reintroduction, and the increased risk of osteoporosis substantiates the need for a GFD in silent patients.
Serologic and Genetic Markers of Celiac Disease: A Sequential Study in the Screening of First Degree Relatives
CD prevalence in this series was seen as very high, and data suggest an accurate algorithm to select candidates for intestinal biopsy among CD high-risk subjects.
Mechanisms of Disease: immunopathogenesis of celiac disease
Observations now point towards a central role for the gluten-induced innate stress response in the pathogenesis of celiac disease and its malignant complications.
Integration of genetic and immunological insights into a model of celiac disease pathogenesis.
Comparison of genetic pathways as well as genetic susceptibility loci between CD and other autoimmune and inflammatory disorders reveals that CD bears stronger resemblance to T cell-mediated organ-specific autoimmune than to inflammatory diseases.