Display options
Cite
Riznik P, Balogh M, Bódi P, et al. The Use of Biopsy and "No-Biopsy" Approach for Diagnosing Paediatric Coeliac Disease in the Central European Region. Gastroenterol Res Pract. 2019;2019:9370397doi: 10.1155/2019/9370397.
Riznik, P., Balogh, M., Bódi, P., De Leo, L., Dolinsek, J., Guthy, I., Gyimesi, J., Horváth, �. �., Kis, I., Klemenak, M., Koletzko, B., Koletzko, S., Korponay-Szabó, I. R., Krencnik, T., Not, T., Palcevski, G., Pollák, �. �., Sblattero, D., Tokodi, I., Vogrincic, M., Werkstetter, K. J., & Dolinsek, J. (2019). The Use of Biopsy and "No-Biopsy" Approach for Diagnosing Paediatric Coeliac Disease in the Central European Region. Gastroenterology research and practice, 20199370397. https://doi.org/10.1155/2019/9370397
Riznik, Petra, et al. "The Use of Biopsy and "No-Biopsy" Approach for Diagnosing Paediatric Coeliac Disease in the Central European Region." Gastroenterology research and practice vol. 2019 (2019): 9370397. doi: https://doi.org/10.1155/2019/9370397
Riznik P, Balogh M, Bódi P, De Leo L, Dolinsek J, Guthy I, Gyimesi J, Horváth Á, Kis I, Klemenak M, Koletzko B, Koletzko S, Korponay-Szabó IR, Krencnik T, Not T, Palcevski G, Pollák É, Sblattero D, Tokodi I, Vogrincic M, Werkstetter KJ, Dolinsek J. The Use of Biopsy and "No-Biopsy" Approach for Diagnosing Paediatric Coeliac Disease in the Central European Region. Gastroenterol Res Pract. 2019 Nov 15;2019:9370397. doi: 10.1155/2019/9370397. eCollection 2019. PMID: 31827506; PMCID: PMC6885281.
Copy Download .nbib Format: NLM
Share it on

Gastroenterol Res Pract. 2019 Nov 15;2019:9370397. doi: 10.1155/2019/9370397. eCollection 2019.

The Use of Biopsy and "No-Biopsy" Approach for Diagnosing Paediatric Coeliac Disease in the Central European Region.

Gastroenterology research and practice

Petra Riznik, Márta Balogh, Piroska Bódi, Luigina De Leo, Jasmina Dolinsek, Ildikó Guthy, Judit Gyimesi, Ágnes Horváth, Ildikó Kis, Martina Klemenak, Berthold Koletzko, Sibylle Koletzko, Ilma Rita Korponay-Szabó, Tomaz Krencnik, Tarcisio Not, Goran Palcevski, Éva Pollák, Daniele Sblattero, István Tokodi, Matej Vogrincic, Katharina Julia Werkstetter, Jernej Dolinsek

Affiliations

  1. University Medical Centre Maribor, Department of Paediatrics, Gastroenterology, Hepatology and Nutrition Unit, Maribor, Slovenia.
  2. Markusovszky Teaching Hospital, Szombathely, Hungary.
  3. Pándy Kálmán Hospital, Gyula, Hungary.
  4. IRCCS Burlo Garofolo Trieste, Institute for Maternal and Child Health, Trieste, Italy.
  5. Municipality of Maribor, Project Office, Maribor, Slovenia.
  6. Jósa András County Hospital, Nyíregyháza, Hungary.
  7. Heim Pál National Paediatric Institute, Coeliac Disease Centre, Budapest, Hungary.
  8. Csolnoky Ferenc County Hospital, Veszprém, Hungary.
  9. St. Barbara County Hospital, Tatabánya, Hungary.
  10. Stiftung Kindergesundheit (Child Health Foundation) at Dr. von Hauner Children's Hospital, LMU Munich, Munich, Germany.
  11. Dr. von Hauner Children's Hospital, Clinical Medical Centre, LMU Munich, Munich, Germany.
  12. Department of Pediatrics, Gastroenterology and Nutrition, School of Medicine Collegium Medicum University of Warmia and Mazury, Olsztyn, Poland.
  13. University of Debrecen, Faculty of Medicine, Department of Paediatrics, Debrecen, Hungary.
  14. University Hospital Rijeka, Department for Gastroenterology, Paediatric Clinic, Rijeka, Croatia.
  15. Ajka County Hospital, Ajka, Hungary.
  16. University of Trieste, Trieste, Italy.
  17. St. George Fejér County University Teaching Hospital, Székesfehérvár, Hungary.
  18. University Medical Centre Maribor, Department of Informatics, Maribor, Slovenia.
  19. Medical Faculty, Department of Paediatrics, University of Maribor, Maribor, Slovenia.

PMID: 31827506 PMCID: PMC6885281 DOI: 10.1155/2019/9370397

Abstract

OBJECTIVES: The current European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) guidelines introduced the option to diagnose coeliac disease (CD) in children and adolescents without upper endoscopy if the defined criteria are met. The aim of our study was to evaluate how frequently paediatric gastroenterologists in Central Europe used the "no-biopsy" approach and how often the duodenal biopsy could have been omitted.

METHODS: Medical records of patients aged < 19 years diagnosed with CD in 2016 from five European countries were analysed, focusing on levels of transglutaminase antibodies (TGA) at the time of diagnosis and on whether the diagnosis was confirmed using duodenal biopsy or "no-biopsy" approach. Clinical presentation and delays until final diagnosis were analysed according to diagnostic approach.

RESULTS: Data from 653 children (63.9% female, median age: 7 years, range: 7 months-18.5 years) from Croatia, Hungary, Germany, Italy, and Slovenia were analysed. One fifth (

CONCLUSION: In this cohort, about 60% of symptomatic CD patients could have been diagnosed without duodenal biopsies. The aim of the "no-biopsy" approach was to make the diagnostic procedure less challenging without compromising its reliability. However, this option was applied only in 20%, in spite of fewer burdens to the family and reduced costs. The reasons for this discrepancy are unknown. Physicians should be made more aware about the reliability of CD diagnosis without biopsies when the ESPGHAN guidelines for CD diagnosis are followed.

Copyright © 2019 Petra Riznik et al.

Conflict of interest statement

The authors have no conflicts of interest to disclose.

References

  1. Gastroenterology. 2017 Oct;153(4):924-935 - PubMed
  2. Arch Dis Child. 2013 Oct;98(10):806-11 - PubMed
  3. Aliment Pharmacol Ther. 2014 Sep;40(5):422-34 - PubMed
  4. Nat Rev Gastroenterol Hepatol. 2014 Nov;11(11):655-63 - PubMed
  5. J Pediatr Gastroenterol Nutr. 2016 Jul;63(1):156-65 - PubMed
  6. J Gen Intern Med. 2005 Jul;20(7):644-6 - PubMed
  7. Nat Rev Gastroenterol Hepatol. 2018 Jan;15(1):60-66 - PubMed
  8. Turk J Gastroenterol. 2018 Jul;29(4):419-426 - PubMed
  9. Gastroenterology. 2017 Aug;153(2):410-419.e17 - PubMed
  10. J Pediatr Gastroenterol Nutr. 2005 Jan;40(1):1-19 - PubMed
  11. J Pediatr Gastroenterol Nutr. 2012 Jan;54(1):136-60 - PubMed
  12. Dig Dis Sci. 2018 Jun;63(6):1384-1391 - PubMed
  13. J Clin Pathol. 2006 Oct;59(10):1008-16 - PubMed
  14. Gastroenterol Hepatol Bed Bench. 2015 Spring;8(2):99-109 - PubMed
  15. J Pediatr Gastroenterol Nutr. 2018 Dec;67(6):749-754 - PubMed
  16. Saudi Med J. 2015 Jun;36(6):751-3 - PubMed
  17. Indian J Gastroenterol. 2017 Jul;36(4):327-329 - PubMed
  18. Arch Dis Child. 1989 Sep;64(9):1320-4; discussion 1324-5 - PubMed
  19. Arch Dis Child. 1990 Aug;65(8):909-11 - PubMed
  20. Arch Dis Child. 1979 Oct;54(10):783-6 - PubMed

Publication Types