Spanish National Registry of Paediatric Coeliac Disease

Abstract

Objectives:Over the last several decades, there has been a tendency towards a predominance of less symptomatic forms of coeliac disease (CD) and an increase in the patient age at diagnosis. This study aimed to assess the clinical presentation and diagnostic process of paediatric CD in Spain.Methods:A nationwide prospective, observational, multicentre registry of new paediatric CD cases was conducted from January 2011 to June 2017. The data regarding demographic variables, type of birth, breast-feeding history, family history of CD, symptoms, height and weight, associated conditions, serological markers, human leukocyte antigen (HLA) phenotype, and histopathological findings were collected.Results:In total, 4838 cases (61% girls) from 73 centres were registered. The median age at diagnosis was 4 years. Gastrointestinal symptoms were detected in 71.4% of the patients, and diarrhoea was the most frequent symptom (45.9%). The most common clinical presentation was the classical form (65.1%) whereas 9.8% ofthe patients were asymptomatic. There was a trend towards an increase in the age at diagnosis, proportion of asymptomatic CD cases, and usage of anti-deamidated gliadin peptide antibodies and HLA typing for CD diagnosis. There was, however, a decreasing trend in the proportion of patients undergoing biopsies. Some of these significant trend changes may reflect the effects of the 2012 ESPGHAN diagnosis guidelines.Conclusions:Paediatric CD in Spain is evolving in the same direction as in the rest of Europe, although classical CD remains the most common presentation form, and the age at diagnosis remains relatively low.

Correlation of Anti-Tissue Transglutaminase Antibodies With the Mucosal Changes and IgA Status of Children With Celiac Disease

“…Conversely, we were not able to observe a relationship between t-TGA IgG levels and changes of the intestinal mucosa in patients with IgA deficiency. The results obtained may be due to the small sample size, although collecting a larger series is difficult since the overall prevalence of IgA deficiency in CD is 1%–3% (17,18,22). Several publications have reported the utility of t-TGA IgG markers for the diagnostic approach of CD in IgA-deficient individuals (23,24) but to our knowledge there is no previous publication trying to correlate this markers with the severity of intestinal damage.…”

“…Between June 2006 and May 2007 (REPAC 1) (17) and afterwards REPAC 2 was conducted, between January 2011 and June 2017. In this last one, a decreasing trend in the proportion of patients who underwent SBB is shown, a 2.8% monthly decrease from January 2012 to October 2013, without relevant changes after that period, which reflects the effect of the ESPGHAN (2,3) diagnosis guidelines relying in the accuracy of the serological markers (18).…”

JPGN and the Year 2022

“…The clinical presentations of celiac disease were studied using a nationwide prospective, observational, multi-center registry in Spain of new pediatric celiac disease cases (26). From January 2011 to June 2017, 4838 cases (61% girls) from 73 centers were registered.…”