Complementary Serologic Investigations in Children with Celiac Disease Is Unnecessary during Follow-Up
Abstract
Objectives To determine the frequency of nutritional deficiencies and thyroid dysfunction in children with celiac disease (CD) and during follow-up after initiation of a gluten-free diet. Laboratory investigations of hemoglobin, ferritin, calcium, folate, vitamin B12, vitamin D, and thyroid function are regularly ordered in children with CD despite sufficient evidence for these. Study design Between 2009 and 2014, test results of hemoglobin, ferritin, folate, vitamin B12, calcium, vitamin D (25[OH]D), free thyroxin, and thyroid stimulating hormone of children with CD regularly seen at the Leiden University Medical Center were investigated. Laboratory reference ranges were used to define abnormal results. Pearson χ(2) test for trend, unpaired t test, and 1-way ANOVA were used for statistical analysis. Results Of the 182 children evaluated, 119 were newly diagnosed. On average, 17% of results per year were missing because of incomplete blood investigations. Iron deficiency (28%) and iron deficiency anemia (9%) were found at the time of diagnosis of CD. Folate (14%), vitamin B12 (1%), and vitamin D deficiencies (27%) were also seen. No hypocalcemia or thyroid dysfunction was found. At follow-up, iron deficiency, iron deficiency anemia, and folate and vitamin D deficiency were observed in 8%, 2%, 3%, and 25% of patients, respectively. Vitamin B12 deficiency, hypocalcemia, and thyroid disease were not found. Conclusions Complementary blood investigations are relevant at the time o…
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Some studies demonstrate low vitamin D levels at diagnosis in coeliac disease children.
“Some of these demonstrate low vitamin D levels at diagnosis (12, 14, 34-36)”
From ESPGHAN Position Paper on Management and Follow-up of Children and Adolescents With Celiac Disease. (2022) · cites this paper as [14]
Other studies show no added benefit of thyroid disease testing in coeliac disease children in the absence of symptoms.
“However, other studies show no added benefit of thyroid disease testing in CD children in the absence of symptoms (14).”
From ESPGHAN Position Paper on Management and Follow-up of Children and Adolescents With Celiac Disease. (2022) · cites this paper as [14]
In most cases, one year on a strict gluten-free diet is sufficient to restore bone mass in children with coeliac disease.
“Although a longer followup might be needed in some cases to ensure a proper BMD recovery (33), in most cases, one year on a strict GFD is sufficient to restore bone mass (12, 14, 28).”
From ESPGHAN Position Paper on Management and Follow-up of Children and Adolescents With Celiac Disease. (2022) · cites this paper as [14]
In most cases (84%-96%) anaemia improves or recovers on a gluten-free diet.
“In most cases (84%-96%) anaemia improves or recovers on a GFD (14, 64, 67, 70, 72).”
From ESPGHAN Position Paper on Management and Follow-up of Children and Adolescents With Celiac Disease. (2022) · cites this paper as [14]
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ESPGHAN Position Paper on Management and Follow-up of Children and Adolescents With Celiac Disease.
Mearin, M. L., Agardh, D., Antunes, H., Al‐toma, A., Auricchio, R., Castillejo, G., Catassi, C., Ciacci, C., Discepolo, V., Dolinsek, J., et al. (2022) · Journal of pediatric gastroenterology and nutrition · doi:10.1097/mpg.0000000000003540 · Cited by 186 · see citing works
Self-citationE-Healthcare for Celiac Disease—A Multicenter Randomized Controlled Trial
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Self-citationLow Yield for Routine Laboratory Checks in Follow-up of Coeliac Disease
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Self-citation
- Authors
- Wessels, M. M. S., van Veen, I. I., Vriezinga, S. L., Putter, H., Rings, E. H. H. M., & Mearin, M. L.
- Affiliations
- Leiden University Medical Center (NL)
- Venue
- The Journal of Pediatrics
- Publisher
- Elsevier BV
- Published
- 2016-02
- Volume
- 169
- Pages
- 55-60
- ISSN
- 0022-3476 (ISSN-L)
- OpenAlex
- W1953587749
- Cited by
- 61
- References
- 0
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 7 · 2023: 5 · 2022: 6 · 2021: 10 · 2020: 8 · 2019: 6 · 2018: 4 · 2017: 3 · 2016: 6
- FWCI
- 4.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Pediatrics (publishedVersion)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Leiden Repository (Leiden University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Celiac Disease Research and Management
- Health Sciences › Medicine › Surgery › Eosinophilic Esophagitis
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Keywords
- celiac disease, children, gluten-free diet, nutritional deficiency, iron deficiency anemia, iron deficiency, vitamin D deficiency, folate deficiency, vitamin B12 deficiency, hypocalcemia, thyroid dysfunction, unnecessary laboratory testing
- MeSH terms
- Adolescent, Celiac Disease, Child, Female, Follow-Up Studies, Hematologic Tests, Humans, Male, Retrospective Studies, Thyroid Diseases, Unnecessary Procedures, Malnutrition, Diet, Gluten-Free
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