Mass Screening for Celiac Disease: The Autoimmunity Screening for Kids Study

Area of Science:

• Pediatric autoimmune diseases
• Gastroenterology
• Immunology

Background:

• Celiac disease (CD) is an autoimmune disorder triggered by gluten.
• Early detection and management of CD can prevent long-term complications.
• Pediatric screening studies are crucial for identifying undiagnosed cases.

Purpose of the Study:

• To report the celiac disease (CD) outcomes from the initial phase of the Autoimmunity Screening for Kids (ASK) study.
• To determine the prevalence of CD autoimmunity in a pediatric population in Colorado.
• To identify factors associated with positive CD antibody tests.

Main Methods:

• The Autoimmunity Screening for Kids (ASK) study screened 9,973 children aged 1-17 years for CD.
• Two sensitive assays for tissue transglutaminase autoantibodies (TGA) were used: radiobinding (RBA) and electrochemiluminescence (ECL).
• Children with positive TGA results underwent confirmatory testing and further evaluation.

Main Results:

• Of 9,973 children, 242 tested positive for TGA by any assay; 149 confirmed positive by RBA TGA.
• Confirmed positive TGA was associated with family history of CD, non-Hispanic white ethnicity, and female sex.
• Gastrointestinal symptoms were equally common in TGA-positive and TGA-negative children.

Conclusions:

• The ASK study indicates a high prevalence of undiagnosed CD autoimmunity in the screened US pediatric population.
• Initial gastrointestinal symptoms were not associated with TGA status, underscoring the value of screening.
• This mass-screening approach aids in identifying children with CD autoimmunity who may be asymptomatic or have non-specific symptoms.