Current Paediatric Coeliac Disease Screening Strategies and Relevance of Questionnaire Survey

Abstract

Coeliac disease (CD) is an autoimmune enteropathy triggered by the ingestion of gluten-containing grains in genetically predisposed individuals. Identification of CD in clinical practice is often difficult due to the manifestation of non-specific symptoms and signs, so a relatively significant proportion of CD cases remain undiagnosed. Timely detection of the disease is necessary to provide an appropriate approach to control of the disease treatment, in order to avoid potential complications. This is even more important in the case of children and adolescents, to ensure their proper growth and development. In this review, we discuss the data on the current strategies for CD detection among paediatric populations and the role of questionnaire-based discovery of CD cases in the area of interest. We assume that mass screening is a preferable strategy for finding CD cases within the paediatric population because this could uncover symptomatic, oligosymptomatic, and asymptomatic CD cases. However, under conditions of limited financial resources, screening for CD in risk groups, members of which can be identified using questionnaires, is essential. The pros and cons of CD screening in paediatric populations are presented. These depend on a number of situational criteria (cost-effectiveness, lack of awareness), but screening is designed to improve the detection of the disease and therefore improve the quality of life of patients.

Questionnaire‐based survey to determine an at‐risk group for coeliac disease among school children in Moscow, Russia

“…11 While literature reviews by Poddighe et al 12,13 have provided more insights and accuracy into the current knowledge about the prevalence of paediatric CD in several Asian countries, greater publication of such findings on a broader scale are required, to define CD prevalence on a global scale. In the review, 14 the data supporting the current strategies for CD detection among paediatric CD populations had been described. Here, it was postulated that mass screening could be a preferable strategy for accurately mining CD cases within a population cohort, due to the enhanced possibility of uncovering symptomatic, oligosymptomatic, and asymptomatic CD cases.…”

Diagnosis of celiac disease in groups of genetic risk: modern view on the problem

“…The high-risk group includes first-degree relatives of celiac patients (parents, siblings), patients with other autoimmune diseases, endocrinopathies (diabetes mellitus type I (T1DM), autoimmune thyroid disease (AITD), Addison's disease) and genetic diseases (Down's syndrome, Shereshevsky-Turner syndrome), herpetiform dermatitis of Dühring, etc. [23,24].…”

“…Thanks to the introduction and wide use of modern specific serological diagnostic methods (antibodies to tissue transglutaminase (anti-TTG) IgA, IgG, antiendomysial antibody-EMA) it has became possible to conduct screening and epidemiological studies. The screening of celiac disease among patients in the highrisk group is the primary prevention of autoimmune and oncological diseases [24,25].…”

Duodenal Ulceration in a Child with Coeliac Disease

“…The diagnosis of CD in children remains a clinical problem because of the variety of ways in which CD can symptomatically manifest itself. Thus, it is important to investigate and diagnose CD not only in children with obvious gastrointestinal symptoms but also in children with less clear clinical manifestations because of the potential risk it poses to general health at a later stage in life [3][4][5][6]. In older children and adolescents, CD can be identified by numerous non-gastrointestinal symptoms, named as "atypical symptoms", which are in strong contrast to "typical symptoms" that have been previously described as being gastrointestinal and extraintestinal in origin [7,8].…”