PMID- 29916948
OWN - NLM
STAT- MEDLINE
DCOM- 20191125
LR  - 20211204
IS  - 1536-4801 (Electronic)
IS  - 0277-2116 (Linking)
VI  - 67
IP  - 6
DP  - 2018 Dec
TI  - Prospective Evaluation of the ESPGHAN Guidelines for Diagnosis of Celiac Disease 
      in New Zealand Children.
PG  - 749-754
LID - 10.1097/MPG.0000000000002065 [doi]
AB  - OBJECTIVE: The 2012 European Society of Pediatric Gastroenterology, Hepatology 
      and Nutrition (ESPGHAN) guideline for diagnosis of celiac disease (CD) questioned 
      the requirement for intestinal biopsy to confirm the diagnosis. The guideline 
      recommends that in symptomatic patients with consistent human leukocyte antigen 
      (HLA) subtypes, the diagnostic accuracy of strongly positive serology is 
      sufficient to confirm the diagnosis. We prospectively assessed these guidelines 
      in a "real-life" clinical setting. METHODS: One hundred and four children 
      referred for evaluation of possible CD were prospectively recruited. Following 
      informed consent, blood was drawn for serological testing and HLA analysis at 
      upper gastrointestinal endoscopy. Histological findings according to Marsh 
      criteria were correlated with blood results and the accuracy of the guideline 
      analyzed.The study also examined the role of deamidated gliadin peptide (DGP) in 
      the diagnosis of CD. RESULTS: For symptomatic patients with consistent HLA 
      subtypes, strongly positive serology (as described in the ESPGHAN guidelines) 
      accurately predicted biopsy-proven CD in >95% of cases. DGP was positive in fewer 
      patients than anti-TG2 or EMA. Incorporation of DGP as a second confirmatory 
      serological test in place of EMA was associated with maintained predictive value 
      of guideline, but fewer patients fulfilling criteria for biopsy-free diagnosis. 
      CONCLUSIONS: The ESPGHAN guideline performs well in our population. Adoption of 
      the guideline would reduce the number of patients requiring endoscopy without 
      compromise in diagnostic accuracy. The involvement of pediatric 
      gastroenterological expertise, however, remains key to diagnosis of CD.
FAU - Bishop, Jonathan
AU  - Bishop J
AD  - Department of Paediatric Gastroenterology, Starship Children's Health.
FAU - Reed, Peter
AU  - Reed P
AD  - Auckland District Health Board Research Office.
FAU - Austin, Paul
AU  - Austin P
AD  - Department of Virology & Immunology, LabPLUS.
FAU - Hurst, Miriam
AU  - Hurst M
AD  - Department of Clinical Immunology, Auckland City Hospital.
AD  - Department of Immunology, Labtests.
FAU - Ameratunga, Rohan
AU  - Ameratunga R
AD  - Department of Virology & Immunology, LabPLUS.
AD  - Department of Clinical Immunology, Auckland City Hospital.
FAU - Craigie, Alyson
AU  - Craigie A
AD  - Department of Immunology, Labtests.
FAU - McFarlane, Jeannette
AU  - McFarlane J
AD  - Department of Histopathology, Auckland City Hospital, Auckland, New Zealand.
FAU - Chin, Simon E
AU  - Chin SE
AD  - Department of Paediatric Gastroenterology, Starship Children's Health.
FAU - Mouat, Stephen M
AU  - Mouat SM
AD  - Department of Paediatric Gastroenterology, Starship Children's Health.
FAU - Evans, Helen M
AU  - Evans HM
AD  - Department of Paediatric Gastroenterology, Starship Children's Health.
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PL  - United States
TA  - J Pediatr Gastroenterol Nutr
JT  - Journal of pediatric gastroenterology and nutrition
JID - 8211545
RN  - 0 (Autoantibodies)
RN  - 0 (Biomarkers)
RN  - 0 (HLA Antigens)
RN  - 0 (Peptides)
RN  - 9007-90-3 (Gliadin)
RN  - EC 2.3.2.13 (Protein Glutamine gamma Glutamyltransferase 2)
RN  - EC 2.3.2.13 (Transglutaminases)
RN  - EC 3.6.1.- (GTP-Binding Proteins)
SB  - IM
MH  - Adolescent
MH  - Autoantibodies/blood/immunology
MH  - Biomarkers/blood
MH  - Celiac Disease/*diagnosis
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - GTP-Binding Proteins/immunology
MH  - Gastroenterology/*standards
MH  - Gliadin/blood
MH  - HLA Antigens/blood
MH  - Humans
MH  - Male
MH  - New Zealand
MH  - Nutritional Sciences/*standards
MH  - Pediatrics/*standards
MH  - Peptides/blood
MH  - Practice Guidelines as Topic
MH  - Predictive Value of Tests
MH  - Prospective Studies
MH  - Protein Glutamine gamma Glutamyltransferase 2
MH  - Serologic Tests/standards/*statistics & numerical data
MH  - Transglutaminases/immunology
EDAT- 2018/06/20 06:00
MHDA- 2019/11/26 06:00
CRDT- 2018/06/20 06:00
PHST- 2018/06/20 06:00 [pubmed]
PHST- 2019/11/26 06:00 [medline]
PHST- 2018/06/20 06:00 [entrez]
AID - 10.1097/MPG.0000000000002065 [doi]
PST - ppublish
SO  - J Pediatr Gastroenterol Nutr. 2018 Dec;67(6):749-754. doi: 
      10.1097/MPG.0000000000002065.