Screening for Celiac Disease in a Pediatric Primary Care Setting

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Maureen M Leonard1, Rhonda Fogle2, Alexander Asch2

  • 1Massachusetts General Hospital for Children, Boston, MA, USA mleonard7@partners.org.

Clinical Pediatrics
|July 8, 2015
PubMed

Insights

Celiac disease (CD) prevalence in children is rising, mirroring adult rates. Routine screening in primary care found CD in 1:26 at-risk and 1:111 not-at-risk pediatric patients, suggesting increasing undiagnosed cases.

Area of Science:

  • Gastroenterology and Immunology
  • Pediatric Autoimmune Diseases
  • Epidemiology of Celiac Disease

Background:

  • Celiac disease (CD) is an autoimmune disorder triggered by gluten in genetically susceptible individuals.
  • Adult CD prevalence in the US is increasing, yet many cases remain undiagnosed despite improved diagnostics and screening benefits.
  • Pediatric CD diagnosis is crucial for long-term health outcomes.

Purpose of the Study:

  • To determine the prevalence of celiac disease in pediatric patients.
  • To compare CD prevalence between at-risk and not-at-risk children within a primary care setting.
  • To assess the impact of routine CD screening in pediatric populations.

Main Methods:

  • Retrospective review of 2325 pediatric patient records over a 5-year period.
  • Serological testing using immunoglobulin A tissue transglutaminase (tTG) antibodies.
  • Categorization of patients into 'at-risk' and 'not-at-risk' groups for CD.

Main Results:

  • The prevalence of celiac disease in at-risk pediatric patients was 1:26.
  • The prevalence of celiac disease in not-at-risk pediatric patients was 1:111.
  • CD prevalence in children approximates US adult rates.

Conclusions:

  • Celiac disease prevalence in children is significant, even in those without known risk factors.
  • Routine screening for celiac disease in primary care pediatric practices is effective in identifying cases.
  • The findings suggest a potential increase in undiagnosed celiac disease among children, including those without apparent risk factors.

Keywords:
adolescentautoantibodiesbloodceliac diseasechilddiagnosisepidemiologyprevalencerisk factorsscreeningtransglutaminases/immunology

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