Screening for Celiac Disease in a Pediatric Primary Care Setting

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.