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Screening for coeliac disease in Dutch children with associated diseases
E K George1, M L Mearin, J Bouquet
1Department of Paediatrics, University Hospital Leiden, The Netherlands.
Insights
Children with Down syndrome have a significantly higher frequency of coeliac disease (CD). Screening for CD using the antiendomysium antibody test is recommended for all individuals with Down syndrome.
Area of Science:
- Pediatric Gastroenterology
- Immunology
- Genetics
Background:
- Coeliac disease (CD) is an autoimmune disorder.
- Associated disorders, including Down syndrome, juvenile rheumatoid arthritis (JRA), and diabetes mellitus, may have increased CD prevalence.
- The prevalence of CD in specific pediatric populations in Zuid-Holland, Netherlands, requires investigation.
Purpose of the Study:
- To determine the frequency of coeliac disease (CD) in children with associated disorders.
- To evaluate the efficacy of different serological markers for CD screening in these populations.
- To establish recommendations for CD screening in at-risk pediatric groups.
Main Methods:
- Serological screening for CD using IgA-class antigliadin, antiendomysium, and antireticulin antibodies.
- Functional sugar absorption tests were employed.
- Positive screening results were confirmed with jejunal biopsy.
- The antiendomysium antibody test demonstrated superior performance as a screening tool.
Main Results:
- No significant association was found between coeliac disease and diabetes mellitus.
- The prevalence of CD in children with Down syndrome was 7.0%, substantially higher than in the general population.
- One child with juvenile rheumatoid arthritis (JRA) was diagnosed with CD (1.5%), and this child also had Down syndrome.
Conclusions:
- Coeliac disease is significantly more prevalent in children with Down syndrome.
- Screening for coeliac disease is recommended for all individuals with Down syndrome, utilizing at least the antiendomysium antibody test.
- The antiendomysium antibody test is an effective screening method for coeliac disease in pediatric populations with associated disorders.
Abstract:
Our objective was to assess the frequency of coeliac disease in children with associated disorders in the province of "Zuid-Holland". The Netherlands. We therefore screened 115 children with Down's syndrome, 62 children with juvenile rheumatoid arthritis (JRA) and 46 children with diabetes mellitus for CD using the IgA-class of antigliadin, antiendomysium and antireticulin antibodies in serum, and a functional sugar absorption test. The antiendomysium antibody test was the screening test that performed the best. Every patient who has at least one positive test underwent a jejunal biopsy for the diagnosis of CD. No association could be demonstrated between CD and diabetes mellitus. The frequency of CD in Down's syndrome was 7.0%, which is much higher than that found from screening the general population. CD was found in one child with JRA (1.5%), who also had Down's syndrome. We recommend screening for CD in all persons with Down's syndrome using at least the antiendomysium antibody test.