Hill ID, Dirks MH, Liptak GS, et al. Guideline for the diagnosis and treatment of celiac disease in children: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition

North American Society for Pediatric Gastroenterology, Hepatology and Nutrition, Flourtown, PA 19031, USA.
Journal of Pediatric Gastroenterology and Nutrition (Impact Factor: 2.87). 02/2005; 40(1):1-19. DOI: 10.1097/00005176-200501000-00001
Source: PubMed

ABSTRACT Celiac disease is an immune-mediated enteropathy caused by a permanent sensitivity to gluten in genetically susceptible individuals. It occurs in children and adolescents with gastrointestinal symptoms, dermatitis herpetiformis, dental enamel defects, osteoporosis, short stature, delayed puberty and persistent iron deficiency anemia and in asymptomatic individuals with type 1 diabetes, Down syndrome, Turner syndrome, Williams syndrome, selective immunoglobulin (Ig)A deficiency and first degree relatives of individuals with celiac disease. The Celiac Disease Guideline Committee of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition has formulated a clinical practice guideline for the diagnosis and treatment of pediatric celiac disease based on an integration of a systematic review of the medical literature combined with expert opinion. The Committee examined the indications for testing, the value of serological tests, human leukocyte antigen (HLA) typing and histopathology and the treatment and monitoring of children with celiac disease. It is recommended that children and adolescents with symptoms of celiac disease or an increased risk for celiac disease have a blood test for antibody to tissue transglutaminase (TTG), that those with an elevated TTG be referred to a pediatric gastroenterologist for an intestinal biopsy and that those with the characteristics of celiac disease on intestinal histopathology be treated with a strict gluten-free diet. This document represents the official recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition on the diagnosis and treatment of celiac disease in children and adolescents.

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Available from: Karoly Horvath, Aug 18, 2015
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    • "This condition leads the patients to an inflammatory enteropathy, with villous atrophy of the intestinal mucosa, crypt hyperplasia, and an inflammatory infiltrate in the adjacent connective tissue, associated with an increase of intraepithelial lymphocytes [2]. A considerable increase in the prevalence of CD has been recorded, ranging from 1 : 85 to 1 : 300 according to the considered geographic area [3], probably due to the wheatconsuming affluent societies of the western world and to the improved reliability of serological tests (measurement of antitransglutaminase antibodies tTG and antiendomysium antibodies EMA) recorded in the recent decades. "
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    ABSTRACT: Patients involved on coeliac disease (CD) have atypical symptoms and often remain undiagnosed. Specific oral manifestations are effective risk indicators of CD and for this reason an early diagnosis with a consequent better prognosis can be performed by the dentist. There are not researches analysing the frequency of these oral manifestations in potential coeliac patients. The aim of this study is to investigate the oral hard and soft tissue lesions in potential and ascertained coeliac children in comparison with healthy controls. 50 ascertained children, 21 potential coeliac patients, and 54 controls were recruited and the oral examination was performed. The overall oral lesions were more frequently present in CD patients than in controls. The prevalence of oral soft tissue lesions was 62% in ascertained coeliac, 76.2% in potential coeliac patients, and 12.96% in controls (P < 0.05). Clinical dental delayed eruption was observed in 38% of the ascertained coeliac and 42.5% of the potential coeliac versus 11.11% of the controls (P < 0.05). The prevalence of specific enamel defects (SED) was 48% in ascertained coeliac and 19% in potential coeliac versus 0% in controls (P < 0.05; OR = 3.923). The SED seem to be genetically related to the histological damage and villous atrophy.
    Gastroenterology Research and Practice 08/2014; 2014:934159. DOI:10.1155/2014/934159 · 1.75 Impact Factor
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    • "Depuis plusieurs années, les cliniciens et les chercheurs travaillent a ` la mise au point de marqueurs non invasifs, simples a ` mettre en oeuvre, peu coûteux et disponibles même dans les pays moins favorisés, pour réduire la lourdeur de la procédure diagnostique actuelle incluant une fibroscopie oesogastroduodénale. 2. Critères historiques du diagnostic En 1990, la Société européenne de gastroentérologie pédiatrique (ESPGAN) a révisé les critères diagnostiques chez l'enfant en soulignant que le diagnostic pouvait e ˆtre e ´tabli a ` partir d'une suspicion ou d'une histoire clinique e ´vocatrice, si le sujet présentait a ` la fois une positivité des auto-anticorps avec une atrophie villositaire intestinale associée a ` une augmentation des lymphocytes intra-e ´pithéliaux et une rémission nette des symptômes après mise au régime sans gluten [3]. Globalement, cette stratégie diagnostique e ´tait universellement reconnue et appliquée [4] [5]. Elle a e ´galement e ´té validée par les sociétés savantes s'occupant de malades adultes. "
    Archives de Pédiatrie 02/2014; 21(3). DOI:10.1016/j.arcped.2013.12.022 · 0.41 Impact Factor
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    • "Celiac disease is a permanent intolerance to gluten. Celiac disease relates specifically to the composition of the storage proteins present in many common cereals such as wheat, rye, barley and oat, which are harmful for the sensitive consumers (Hill et al., 2005). Unfortunately, the gluten-forming proteins are fundamental for the production of a great variety of foods, including pasta, which is generally made from durum wheat. "
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    ABSTRACT: The manufacture and characterization of gluten-free spaghetti based on maize flour and different vegetable flours (artichoke, asparagus, pumpkin, zucchini, tomato, yellow pepper, red pepper, green pepper, carrot, broccoli, spinach, eggplant and fennel) were addressed in this study. The screening of the vegetable flours showed that homogeneity, color, fibrous, taste and odor were the parameters that have most influenced the overall quality of the dry spaghetti. The spaghetti added with yellow pepper flour was chosen for further analysis because of its highest sensory quality; in contrast, it recorded low carotenoids content due to the high temperature of the drying process (cycle named as HTDC). Therefore, an optimization of the drying cycle was performed (lower temperature) on the yellow pepper flour (cycle named as LTDC) that resulted in an increase of the carotenoids content. Although the spaghetti with low temperature yellow pepper flour had a higher cooking loss and lower instrumental hardness when compared to the spaghetti made with only maize flour (CTRL) it however had a significantly higher protein and dietary fiber content. Moreover there was no significant difference in the amount of glucose released during in vitro digestion for this spaghetti sample with respect to the CTRL sample.
    Journal of Cereal Science 05/2013; 57(3):333–342. DOI:10.1016/j.jcs.2012.12.010 · 1.94 Impact Factor
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