PMID- 31486579
OWN - NLM
STAT- MEDLINE
DCOM- 20200324
LR  - 20200324
IS  - 1442-200X (Electronic)
IS  - 1328-8067 (Linking)
VI  - 61
IP  - 10
DP  - 2019 Oct
TI  - Score-based diagnostic approach to celiac disease and bone mineral density.
PG  - 1015-1019
LID - 10.1111/ped.14002 [doi]
AB  - BACKGROUND: The aim of this study was to assess the performance of a score-based 
      diagnostic approach (SBDA) proposed in the European Society for Paediatric 
      Gastroenterology, Hepatology and Nutrition (ESPGHAN) 2012 guideline, and the 
      usefulness of bone mineral density (BMD) measurement in SBDA as an objective 
      finding in the diagnosis of celiac disease (CD). METHODS: The SBDA scores of 153 
      biopsy-proven celiac diagnosed children (derived from symptomatology, serology, 
      human leukocyte antigen [HLA] analysis, histology) were calculated. Additionally, 
      BMD Z scores obtained at diagnosis were also investigated. The diagnostic 
      sensitivity of SBDA was tested in different scenarios in which low BMD was scored 
      as a diagnostic finding. RESULTS: The mean age of children was 9.48 +/- 3.59 years 
      and 54.2% were female. All patients scored >/=4, which is the minimum score to 
      diagnose CD in SBDA. Mean BMD Z score in 142 of 153 patients was -2.70 +/- 1.16, 
      and 73.9% of them were below -2. Moreover, different diagnostic scenarios without 
      histology were tested. In one of them, BMD and HLA were not included and the 
      sensitivity was 85.2%. In another one, low BMD was scored as an equivalent of 
      malabsorption, HLA was not included and sensitivity was 97.2%. The sensitivities 
      of these scenarios were significantly different (P = 0.001). CONCLUSION: In the 
      absence of both HLA and histology, accepting low BMD as an equivalent of 
      malabsorption drastically increased the diagnostic sensitivity, while SBDA had 
      limited success. Therefore, BMD might be useful when HLA and biopsy are not 
      available.
CI  - (c) 2019 Japan Pediatric Society.
FAU - Coskun, Mehmet Enes
AU  - Coskun ME
AUID- ORCID: 0000-0003-2238-188X
AD  - Department of Paediatrics, University of Gaziantep, Ankara, Turkey.
FAU - Hizli, Samil
AU  - Hizli S
AUID- ORCID: 0000-0001-6732-493X
AD  - Department of Paediatric Gastroenterology, Hepatology and Nutrition, Ankara 
      Yildirim Beyazit University, Ankara, Turkey.
FAU - Yavuz, Sibel
AU  - Yavuz S
AUID- ORCID: 0000-0002-6768-238X
AD  - Department of Paediatric Gastroenterology, Hepatology and Nutrition, Adana 
      Cukurova University, Adana, Turkey.
FAU - Temel, Munevver Tugba
AU  - Temel MT
AUID- ORCID: 0000-0001-8636-6641
AD  - Department of Paediatrics, University of Gaziantep, Ankara, Turkey.
LA  - eng
GR  - TF.13.08/Gaziantep Universitesi/
PT  - Journal Article
PL  - Australia
TA  - Pediatr Int
JT  - Pediatrics international : official journal of the Japan Pediatric Society
JID - 100886002
SB  - IM
MH  - Algorithms
MH  - Bone Diseases, Metabolic/*diagnosis/etiology
MH  - Celiac Disease/complications/*diagnosis
MH  - Child
MH  - Female
MH  - *Health Status Indicators
MH  - Humans
MH  - Male
MH  - Retrospective Studies
MH  - Sensitivity and Specificity
OTO - NOTNLM
OT  - bone mineral density
OT  - celiac disease
OT  - score-based diagnostic approach
EDAT- 2019/09/06 06:00
MHDA- 2020/03/25 06:00
CRDT- 2019/09/06 06:00
PHST- 2019/05/08 00:00 [received]
PHST- 2019/06/21 00:00 [accepted]
PHST- 2019/09/06 06:00 [pubmed]
PHST- 2020/03/25 06:00 [medline]
PHST- 2019/09/06 06:00 [entrez]
AID - 10.1111/ped.14002 [doi]
PST - ppublish
SO  - Pediatr Int. 2019 Oct;61(10):1015-1019. doi: 10.1111/ped.14002.