European Society for Pediatric Gastroenterology, Hepatology, and Nutrition Guidelines for the Diagnosis of Coeliac Disease
Open accessAbstract
Objective: Diagnostic criteria for coeliac disease (CD) from the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) were published in 1990. Since then, the autoantigen in CD, tissue transglutaminase, has been identified; the perception of CD has changed from that of a rather uncommon enteropathy to a common multiorgan disease strongly dependent on the haplotypes human leukocyte antigen (HLA)‐DQ2 and HLA‐DQ8; and CD‐specific antibody tests have improved. Methods: A panel of 17 experts defined CD and developed new diagnostic criteria based on the Delphi process. Two groups of patients were defined with different diagnostic approaches to diagnose CD: children with symptoms suggestive of CD (group 1) and asymptomatic children at increased risk for CD (group 2). The 2004 National Institutes of Health/Agency for Healthcare Research and Quality report and a systematic literature search on antibody tests for CD in paediatric patients covering the years 2004 to 2009 was the basis for the evidence‐based recommendations on CD‐specific antibody testing. Results: In group 1, the diagnosis of CD is based on symptoms, positive serology, and histology that is consistent with CD. If immunoglobulin A anti‐tissue transglutaminase type 2 antibody titers are high (>10 times the upper limit of normal), then the option is to diagnose CD without duodenal biopsies by applying a strict protocol with further laboratory tests. In group 2, the diagnosis of CD is based on positive serology and histology. HLA‐DQ2 and HLA‐DQ8 testing is valuable because CD is unlikely if both haplotypes are negative. Conclusions: The aim of the new guidelines was to achieve a high diagnostic accuracy and to reduce the burden for patients and their families. The performance of these guidelines in clinical practice should be evaluated prospectively.
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The literature search was performed in PubMed or Medline for articles published in English from January 2010 to March 2020, relevant to children and adolescents (<18 years) diagnosed with coeliac disease according to ESPGHAN criteria.
“We searched in PubMed or in Medline for articles published in English from January 2010 to March 2020, relevant to children and adolescents (<18 years) diagnosed with CD according to the ESPGHAN criteria (2,3).”
From ESPGHAN Position Paper on Management and Follow-up of Children and Adolescents With Celiac Disease. (2022) · cites this paper as [2]
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- Authors
- Husby, S., Koletzko, S., Korponay‐Szabó, I. R., Mearin, M. L., Phillips, A., Shamir, R., Troncone, R., Giersiepen, K., Branski, D., Catassi, C., Lelgeman, M., Mäki, M., Ribes‐Koninckx, C., Ventura, A., Zimmer, K. P., ESPGHAN Working Group on Coeliac Disease Diagnosis, & ESPGHAN Gastroenterology Committee
- Affiliations
- Odense University Hospital (DK)
- Ludwig-Maximilians-Universität München (DE)
- University of Debrecen Medical and Health Science Center
- Leiden University Medical Center (NL)
- University College London (GB)
- Tel Aviv University (IL)
- University of Naples Federico II (IT)
- University of Bremen (DE)
- Marche Polytechnic University (IT)
- Tampere University Hospital (FI)
- University of Trieste (IT)
- Justus-Liebig-Universität Gießen (DE)
- Corresponding author
- Husby, S.
- Giersiepen, K.
- Venue
- Journal of Pediatric Gastroenterology and Nutrition
- Publisher
- Wiley
- Published
- 2012-01
- Volume
- 54
- Issue
- 1
- Pages
- 136-160
- ISSN
- 0277-2116 (ISSN-L)
- 1536-4801
- OpenAlex
- W2100548379
- Cited by
- 2,683
- References
- 0
- Citations by year
- 2026: 80 · 2025: 105 · 2024: 138 · 2023: 126 · 2022: 162 · 2021: 232 · 2020: 221 · 2019: 227 · 2018: 225 · 2017: 211 · 2016: 233 · 2015: 235 · 2014: 221 · 2013: 167 · 2012: 90
- FWCI
- 158.23
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- Locations
- Journal of Pediatric Gastroenterology and Nutrition (publishedVersion)
- PubMed (publishedVersion)
- University of Southern Denmark Research Portal (University of Southern Denmark) (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Leiden Repository (Leiden University) (submittedVersion)
- ArTS Archivio della ricerca di Trieste (University of Trieste https://www.units.it/) (submittedVersion)
- University of Debrecen Electronic Archive (University of Debrecen) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Gastroenterology › Celiac Disease Research and Management
- Health Sciences › Medicine › Surgery › Eosinophilic Esophagitis
- Life Sciences › Agricultural and Biological Sciences › Plant Science › Wheat and Barley Genetics and Pathology
- Keywords
- celiac disease, diagnostic criteria, pediatric celiac disease, anti-tissue transglutaminase antibodies, HLA-DQ2, HLA-DQ8, serological diagnosis, duodenal biopsy, diagnostic accuracy, ESPGHAN guidelines
- MeSH terms
- Adolescent, Celiac Disease, Child, Duodenum, HLA-DQ Antigens, Humans, Immunoglobulin A, Transglutaminases
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