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Diagnosis and management of coeliac disease in children

Siba Prosad Paul1, Abeeran Ranjan1, Gillian Bremner1

  • 1Consultant Paediatrician, Yeovil District Hospital, Yeovil.

British Journal of Nursing (Mark Allen Publishing)
|July 12, 2021
PubMed

Insights

Coeliac disease (CD) is an autoimmune disorder affecting about 1% of the population. Early diagnosis and lifelong gluten-free diet are crucial for managing pediatric CD, though many cases remain undiagnosed.

Area of Science:

  • Pediatric Gastroenterology
  • Immunology
  • Clinical Nutrition

Background:

  • Coeliac disease (CD) is a prevalent autoimmune disorder triggered by gluten ingestion.
  • Despite a 1% prevalence, approximately two-thirds of pediatric cases remain undiagnosed.
  • Early detection and management are vital to prevent long-term complications.

Purpose of the Study:

  • To discuss current diagnostic pathways for pediatric coeliac disease.
  • To highlight the 2020 European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) diagnostic guidance.
  • To emphasize the importance of early recognition and management by healthcare professionals.

Main Methods:

  • Review of current diagnostic guidelines for pediatric coeliac disease.
  • Discussion of serological screening using anti-tissue transglutaminase (tTG) antibodies.
  • Emphasis on referral to specialists for confirmed diagnosis.

Main Results:

  • Serological screening with anti-tTG titres is recommended when coeliac disease is suspected.
  • Positive screening results necessitate referral to a coeliac disease specialist for diagnostic confirmation.
  • The 2020 ESPGHAN guidelines provide updated diagnostic approaches.

Conclusions:

  • Lifelong adherence to a strict gluten-free diet is essential for managing coeliac disease.
  • Nurses and specialist pediatric dietitians play a critical role in early diagnosis and ongoing support.
  • Improved diagnostic strategies are needed to address the significant proportion of undiagnosed pediatric coeliac disease.

Keywords:
ChildrenCoeliac diseaseDiagnosisGluten-free

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