European Society for Pediatric Gastroenterology, Hepatology, and Nutrition Guidelines for the Diagnosis of Coeliac Disease

被引:1870
作者
Husby, S. [1 ]
Koletzko, S. [2 ]
Korponay-Szabo, I. R. [3 ]
Mearin, M. L. [4 ]
Phillips, A. [5 ]
Shamir, R. [6 ]
Troncone, R. [7 ,8 ]
Giersiepen, K. [9 ]
Branski, D.
Catassi, C. [10 ]
Lelgeman, M.
Maki, M. [11 ,12 ]
Ribes-Koninckx, C. [13 ]
Ventura, A. [14 ]
Zimmer, K. P. [15 ]
机构
[1] Odense Univ Hosp, Hans Christian Andersen Childrens Hosp, Odense, Denmark
[2] Univ Munich, Div Paediat Gastroenterol & Hepatol, Dr von Hauner Childrens Hosp, Munich, Germany
[3] Univ Debrecen, Med & Hlth Sci Ctr, Debrecen, Hungary
[4] Leiden Univ, Dept Paediat, Med Ctr, NL-2300 RA Leiden, Netherlands
[5] UCL, Med Sch Paediat & Child Hlth, London WC1E 6BT, England
[6] Tel Aviv Univ, Inst Gastroenterol Nutr & Liver Dis, Schneider Childrens Med Ctr Israel, Sackler Fac Med, Tel Aviv, Israel
[7] Univ Naples Federico II, Dept Paediat, Naples, Italy
[8] Univ Naples Federico II, European Lab Invest Food Induced Dis, Naples, Italy
[9] Univ Bremen, Ctr Social Policy Res, Bremen, Germany
[10] Univ Politecn Marche, Dept Paediat, Marche, Italy
[11] Univ Tampere, Paediat Res Ctr, FIN-33101 Tampere, Finland
[12] Tampere Univ Hosp, Tampere, Finland
[13] La Fe Univ Hosp, Valencia, Spain
[14] Univ Trieste, Dept Paediat, IRCCS Burlo Garofolo, I-34127 Trieste, Italy
[15] Univ Giessen, Dept Gen Paediat & Neonatol, D-35390 Giessen, Germany
关键词
SMALL-BOWEL BIOPSY; DEAMIDATED GLIADIN PEPTIDES; SELECTIVE IGA DEFICIENCY; HUMAN-LEUKOCYTE ANTIGENS; SMALL-INTESTINAL-MUCOSA; DUODENAL BULB BIOPSIES; ALPHA-BETA-HETERODIMER; CLASS-II ALLELES; T-CELL LYMPHOMA; TISSUE TRANSGLUTAMINASE;
D O I
10.1097/MPG.0b013e31821a23d0
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Objective: Diagnostic criteria for coeliac disease (CD) from the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESP-GHAN) 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.
引用
收藏
页码:136 / 160
页数:25
相关论文
共 154 条
[31]   Comparison of the interobserver reproducibility with different histologic criteria used in celiac disease [J].
Corazza, Gino Roberto ;
Villanacci, Vincenzo ;
Zambelli, Claudia ;
Milione, Massimo ;
Luinetti, Ombretta ;
Vindigni, Carla ;
Chioda, Caterina ;
Albarello, Luca ;
Bartolini, Daniela ;
Donato, Francesco .
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY, 2007, 5 (07) :838-843
[32]   Coeliac disease [J].
Corazza, GR ;
Villanacci, V .
JOURNAL OF CLINICAL PATHOLOGY, 2005, 58 (06) :573-574
[33]   Accuracy and cost-effectiveness of a new strategy to screen for celiac disease in children with Down syndrome [J].
Csizmadia, CGDS ;
Mearin, ML ;
Oren, A ;
Krombout, A ;
Crusius, JBA ;
von Blomberg, BME ;
Peña, AS ;
Wiggers, MNL ;
Vandenbroucke, JP .
JOURNAL OF PEDIATRICS, 2000, 137 (06) :756-761
[34]   Prediction of Clinical and Mucosal Severity of Coeliac Disease and Dermatitis Herpetiformis by Quantification of IgA/IgG Serum Antibodies to Tissue Transglutaminase [J].
Dahlbom, Ingrid ;
Korponay-Szabo, Ilma R. ;
Kovacs, Judit B. ;
Szalai, Zsuzsanna ;
Maki, Markku ;
Hansson, Tony .
JOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION, 2010, 50 (02) :140-146
[35]   Serologic markers of celiac disease in psoriatic patients [J].
Damasiewicz-Bodzek, A. ;
Wielkoszynski, T. .
JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY, 2008, 22 (09) :1055-1061
[36]  
del Prado MYR, 2001, REV ESP ENFERM DIG, V93, P110
[37]   Antitissue transglutaminase antibodies in acute coronary syndrome:: an alert signal of myocardial tissue lesion? [J].
Di Tola, M. ;
Barilla, F. ;
Trappolini, M. ;
Palumbo, H. F. ;
Gaudio, C. ;
Picarelli, A. .
JOURNAL OF INTERNAL MEDICINE, 2008, 263 (01) :43-51
[38]   Association between serum levels of total IgA and IgA class endomysial and antigliadin antibodies: Implications for coeliac disease screening [J].
Dickey, W ;
McMillan, SA ;
McCrum, EE ;
Evans, AE .
EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY, 1997, 9 (06) :559-562
[39]   Coeliac disease: an update for pathologists [J].
Dickson, B. C. ;
Streutker, C. J. ;
Chetty, R. .
JOURNAL OF CLINICAL PATHOLOGY, 2006, 59 (10) :1008-1016
[40]   Identification of tissue transglutaminase as the autoantigen of celiac disease [J].
Dieterich, W ;
Ehnis, T ;
Bauer, M ;
Donner, P ;
Volta, U ;
Riecken, EO ;
Schuppan, D .
NATURE MEDICINE, 1997, 3 (07) :797-801