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Follow-up of children with celiac disease - lost in translation?

Yael Mozer-Glassberg1, Noam Zevit, Yoram Rosenbach

  • 1Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach Tikva, Israel. yaelm3@clalit.org.il

Digestion
|February 2, 2011
PubMed

Insights

Follow-up care for pediatric celiac disease (CD) patients is inadequate, with many lost to follow-up. Improved monitoring is crucial for ensuring adherence to a gluten-free diet (GFD) and better patient outcomes.

Area of Science:

  • Pediatric Gastroenterology
  • Autoimmune Diseases
  • Dietary Management

Background:

  • Celiac disease (CD) is a common autoimmune disorder requiring a lifelong gluten-free diet (GFD).
  • Presentations of CD vary widely, necessitating comprehensive diagnostic and management strategies.
  • Adequate follow-up care is essential for monitoring treatment adherence and patient health.

Purpose of the Study:

  • To evaluate the presentation of celiac disease in children.
  • To assess adherence to a gluten-free diet (GFD).
  • To determine the adequacy of follow-up care for pediatric CD patients at a tertiary referral center.

Main Methods:

  • Retrospective electronic chart review of pediatric patients suspected of CD.
  • Inclusion criteria: patients seen at the institute between January 1999 and December 2008.
  • Data collected: presenting symptoms, associated conditions, follow-up care, and serological outcomes.

Main Results:

  • 387 children diagnosed with CD; common presentations included iron deficiency anemia, short stature, and abdominal pain.
  • Only 42.7% had regular gastroenterologist visits; 35.5% were lost to follow-up.
  • Patients followed at the center showed significantly better negative serology rates compared to those followed by primary care physicians (p = 0.0002).

Conclusions:

  • Follow-up care for pediatric celiac disease patients at the referral center is insufficient.
  • Enhanced initiatives are needed to improve regular patient follow-up.
  • Improved follow-up is associated with increased adherence to a long-term gluten-free diet.
Abstract

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