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Cited by 48Celiac Disease Research and ManagementEosinophilic EsophagitisChild Nutrition and Feeding Issues

At-Risk Screened Children with Celiac Disease are Comparable in Disease Severity and Dietary Adherence to Those Found because of Clinical Suspicion: A Large Cohort Study

Kivelä, Laura, Kaukinen, Katri, Huhtala, Heini, Lähdeaho, Marja-Leena, Mäki, Markku, Kurppa, Kalle·2017·The Journal of Pediatrics
DOI 10.1016/j.jpeds.2016.12.077
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Abstract

Objective To assess whether children at risk for celiac disease should be screened systematically by comparing their baseline and follow-up characteristics to patients detected because of clinical suspicion. Study design Five hundred four children with celiac disease were divided into screen-detected (n = 145) and clinically detected cohorts (n = 359). The groups were compared for clinical, serologic, and histologic characteristics and laboratory values. Follow-up data regarding adherence and response to gluten-free diet were compared. Subgroup analyses were made between asymptomatic and symptomatic screen-detected patients. Results Of screen-detected patients, 51.8% had symptoms at diagnosis, although these were milder than in clinically detected children (P < .001). Anemia (7.1% vs 22.9%, P < .001) and poor growth (15.7% vs 36.9%, P < .001) were more common, and hemoglobin (126 g/l vs 124 g/l, P = .008) and albumin (41.0 g/l vs 38.0 g/l, P = .016) were lower in clinically detected patients. There were no differences in serology or histology between the groups. Screen-detected children had better dietary adherence (91.2% vs 83.2%, P = .047). The groups showed equal clinical response (97.5% vs 96.2%, P = .766) to the gluten-free diet. In subgroup analysis among screen-detected children, asymptomatic patients were older than symptomatic (9.0 vs 5.8 years of age, P = .007), but the groups were comparable in other variables. Conclusions More than one-half of the screen-detected patients with celiac disease had symptoms unrecognized at diagnosis. The severity of histologic damage, antibody levels, dietary adherence, and response to treatment in screen-detected cases is comparable with those detected on a clinical basis. The results support active screening for celiac disease among at-risk children.

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  • Anaemia is a frequent finding (12-24%) in children with untreated celiac disease.

    “Anaemia is a frequent finding (12-24%) in children with untreated CD (64, 67-70).”

    From ESPGHAN Position Paper on Management and Follow-up of Children and Adolescents With Celiac Disease. (2022) · cites this paper as [69]

    The Abstract (p. 2) reports anemia at diagnosis in 22.9% of clinically detected children, within the claimed range. It reports 7.1% in screen-detected children, however, so the paper does not support 12–24% as a range applying to children with untreated celiac disease generally. (LLM, conf=0.88)

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Cited by

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Authors
Kivelä, L., Kaukinen, K., Huhtala, H., Lähdeaho, M.-L., Mäki, M., & Kurppa, K.
Affiliations
  • Tampere University Hospital (FI)
  • University of Tampere (FI)
Corresponding author
Kurppa, Kalle
ORCID
Venue
The Journal of Pediatrics
Publisher
Elsevier BV
Published
2017-04
Volume
183
Pages
115-121.e2
ISSN
0022-3476 (ISSN-L)
DOI
10.1016/j.jpeds.2016.12.077
OpenAlex
W2581875041
Cited by
48
References
1
Citations by year
2026: 5 · 2025: 3 · 2024: 4 · 2023: 4 · 2022: 4 · 2021: 6 · 2020: 6 · 2019: 1 · 2018: 9 · 2017: 6
FWCI
6.34
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The Journal of Pediatrics (publishedVersion)
  • PubMed (publishedVersion)
  • Tampere University Institutional Repository (Tampere University) (acceptedVersion)
  • Tampere University Institutional Repository (Tampere University) (submittedVersion)
Funders
  • Academy of Finland Research Council for Health
  • Tampere University Hospital
  • Sigrid Juselius Foundation
  • Mary and Georg Ehrnrooth Foundation
  • Foundation for Pediatric Research
  • Finnish Medical Foundation
  • Finnish Celiac Society
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, celiac disease screening, children, asymptomatic celiac disease, gluten-free diet adherence, disease severity, serological markers, intestinal histology, anemia, low growth, clinical suspicion, vulnerable children
MeSH terms
Adolescent, Celiac Disease, Child, Child, Preschool, Female, Follow-Up Studies, Humans, Male, Mass Screening, Patient Compliance, Predictive Value of Tests, Quality of Life, Retrospective Studies, Severity of Illness Index, Cohort Studies, Databases, Factual, Treatment Outcome, Risk Assessment, Diet, Gluten-Free

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