Related Experiment Video
Updated: May 9, 2025
A High-Throughput Multiplexed Screening for Type 1 Diabetes, Celiac Diseases, and COVID-19
Published on: July 5, 2022
Case Finding for Celiac Disease With a Point-of-Care Test
Caroline R Meijer-Boekel1, Lucy Smit2, M Elske van den Akker-van Marle3
1Department of Pediatric Gastroenterology, Leiden University Medical Center, Willem Alexander Children's Hospital, Leiden, the Netherlands.
Insights
Implementing case finding for celiac disease (CD) in young children at Dutch Preventive Youth Health Care Centers (YHCCs) is effective. This approach significantly increases early CD diagnosis compared to standard care, improving child health outcomes.
Area of Science:
- Pediatric Gastroenterology
- Public Health
- Preventive Medicine
Background:
- Celiac disease (CD) is frequently underdiagnosed, leading to severe health complications and increased healthcare burdens.
- Early diagnosis and treatment of CD are crucial for mitigating long-term morbidity and mortality.
Purpose of the Study:
- To prospectively evaluate the feasibility and effectiveness of implementing a case-finding strategy for celiac disease in young children.
- To assess the diagnostic yield of point-of-care testing for celiac disease autoantibodies within a preventive youth health care setting.
Main Methods:
- A prospective study involving children aged 1-4 years attending Dutch Preventive Youth Health Care Centers (YHCCs) from February 2019 to January 2022.
- Point-of-care testing for celiac autoantibodies (TGA-IgA/IgG/IgM) was performed in children with at least one CD-associated symptom.
- Diagnostic confirmation involved elevated TGA-IgA levels or specific histopathological findings alongside positive autoantibodies.
Main Results:
- Of 14,917 participating parents, 35.5% reported symptoms. Case finding identified 56 children with confirmed CD (1.7%), with a median age of 2.6 years.
- The incidence rate of CD diagnosed via case finding was 1.67 per 1000 person-years, significantly higher than the standard care rate of 0.14 per 1000 person-years (P < .001).
- Abdominal distention was the only symptom significantly more frequent in children with CD.
Conclusions:
- Case finding for celiac disease using point-of-care tests is both effective and feasible within Dutch Preventive YHCCs.
- Integrating this case-finding strategy into routine care can facilitate timely diagnosis of celiac disease in childhood.
Background/Objectives:
Celiac disease (CD) is underdiagnosed and thus untreated in many cases. Untreated CD may be associated with severe health complications, increased morbidity and mortality, and considerable burdens to health care systems. Our objectives were to prospectively assess whether implementation of case finding in young children at the Dutch Preventive Youth Health Care Centers (YHCCs) is feasible and effective.
Methods:
From February 2019 to January 2022, parents of all children aged 1-4 years attending the YHCCs in the Kennemerland region were invited. If there was at least 1 CD-associated symptom, a point-of-care test was performed onsite to assess the (immunoglobulin [Ig] A/IgG/IgM) celiac autoantibodies against tissue transglutaminase type 2 (TGA). If positive, the child was referred for confirmation of the diagnosis if TGA-IgA was more than 7 times the upper limit of normal or if histopathology showed Marsh 2 or 3 in addition to positive autoantibodies against endomysium.
Results:
A total of 16 289 parents were invited for regular consultation, of whom 14 917 consented to fill in the questionnaire; 5301 (35.5%) reported symptoms. A total of 3203 tests were performed in 3103 children (58.5%; 47.8% female; median age 2.0 y) and was positive in 61 (1.9%). CD was confirmed in 56 children (1.7% [95% CI, 1.46-2.44]; median age 2.6 y). With the exception of abdominal distention (P = .036), symptoms were similarly frequent among children with and without CD. The overall crude incidence rate of CD diagnosed by case finding was 1.67 per 1000 person-years (95% CI, 1.27-2.15), significantly higher than by standard of care (0.14 per 1000 person-years; P < .001).
Conclusion:
Case finding for CD using a point-of-care test is effective and feasible at Dutch Preventive YHCCs. Implementation of case finding into the standard of care will lead to timely diagnosis of CD in childhood.
More Related Videos
06:50A High-Throughput Electrochemiluminescence 7-Plex Assay Simultaneously Screening for Type 1 Diabetes and Multiple Autoimmune Diseases
Published on: May 29, 2020
10:27Recognition of Epidermal Transglutaminase by IgA and Tissue Transglutaminase 2 Antibodies in a Rare Case of Rhesus Dermatitis
Published on: December 15, 2011
Related Concept Videos
01:30Serum Laboratory Studies, Stool Test, Breath Test
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
01:28Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.