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Rate of celiac disease in children: view from the endoscopy suite

Deborah L Preston1, Yoram Elitsur

  • 1Gastroenterology Division, Department of Pediatrics, Marshall University School of Medicine, Huntington, West Virginia.

Journal of Pediatric Gastroenterology and Nutrition
|February 26, 2015
PubMed

Insights

Diagnosing pediatric celiac disease using endoscopy with biopsies yielded similar rates to serology-led diagnosis. Performing adequate intestinal biopsies during endoscopy is key to increasing celiac disease detection in children.

Area of Science:

  • Pediatric Gastroenterology
  • Gastrointestinal Pathology
  • Immunology

Background:

  • The diagnosis of celiac disease in children in the United States may be limited by a

Purpose of the Study:

  • To investigate the rate of celiac disease diagnosed via upper endoscopy (esophagogastroduodenoscopy [EGD]) without prior positive celiac serology compared to diagnoses following positive serology.

Main Methods:

  • Retrospective review of charts from children's first diagnostic EGDs between 2009-2013.
  • Patients with confirmed celiac disease were categorized into histology-led diagnosis (positive EGD/positive serology) and serology-led diagnosis (positive serology/positive histology) groups.

Main Results:

  • Of 761 EGDs reviewed, 15 children (1.97%) had confirmed celiac disease.
  • No significant difference in demographics or symptoms was found between histology-led and serology-led diagnosis groups.
  • The rate of celiac disease detection was comparable between histology-led (1.18%) and serology-led (0.79%) diagnosis approaches (P=0.273).

Conclusions:

  • Endoscopy-led diagnosis rates for pediatric celiac disease are comparable to serology-led approaches.
  • Adequate intestinal biopsies during diagnostic upper endoscopy are recommended to improve celiac disease detection in children.
  • This suggests a potential underestimation of celiac disease due to diagnostic strategy.
Abstract

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