Celiac Disease Nutritional Status and Poor Adherence to Follow-up

Area of Science:

• Pediatric Gastroenterology
• Nutritional Science
• Autoimmune Diseases

Background:

• Celiac disease is an autoimmune disorder triggered by gluten ingestion in susceptible individuals.
• Management involves a strict gluten-free diet, but nutritional status and adherence can be challenging.
• Children with celiac disease require ongoing monitoring for nutritional health and disease management.

Purpose of the Study:

• To evaluate the nutritional status of children diagnosed with biopsy-proven celiac disease.
• To assess changes in nutritional health and anthropometrics over a 1-year follow-up period.
• To determine adherence rates to recommended follow-up protocols in pediatric celiac disease patients.

Main Methods:

• Retrospective chart review of 252 children (ages 0-21) with biopsy-proven celiac disease.
• Data collected between July 1, 2007, and June 30, 2017.
• Analysis of nutritional status, body mass index (BMI) Z-scores, and vitamin levels at diagnosis and 1-year follow-up.

Main Results:

• Most children had adequate nutritional status at diagnosis, with few deficiencies noted, except for vitamin D.
• No significant changes in anthropometrics or vitamin status were observed at the 1-year follow-up.
• Adherence to follow-up appointments was notably poor, with only 39% attending 5 years post-diagnosis.

Conclusions:

• Pediatric celiac disease patients demonstrate good nutritional health at diagnosis but face challenges with long-term follow-up adherence.
• Current proactive follow-up strategies are insufficient to ensure consistent patient engagement.
• Alternative approaches, such as integrating care with primary care providers, are necessary to improve adherence and long-term management.