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How do Swedish paediatric clinics diagnose coeliac disease? Results of a nationwide questionnaire study
Author(s) -
Stenhammar Lars,
Högberg Lotta,
Danielsson Lars,
Ascher Henry,
Dannaeus Anders,
Hernell Olle,
Ivarsson Anneli,
Lindberg Eva,
Lindquist Bo,
Nivenius Kerstin
Publication year - 2006
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1080/08035250600636552
Subject(s) - medicine , coeliac disease , pediatrics , biopsy , disease , gluten free , inflammatory bowel disease
Background and aim: Diagnosis of coeliac disease is based on the demonstration of enteropathy in a small bowel biopsy. Correct diagnosis is of utmost importance, since the need for dietary management is life long, and inadequate treatment may lead to potentially serious complications. The Swedish Working Group for Paediatric Coeliac Disease has published guidelines for the diagnosis of childhood coeliac disease. The present questionnaire was designed in order to create the basis for revision of those guidelines. Methods: In 2004, a nationwide questionnaire concerning current diagnostic routines was sent to all 45 paediatric clinics performing small bowel biopsy. All clinics responded. Results: All clinics base their diagnosis on small bowel biopsy findings at presentation. Furthermore, in 24 (53%) of the clinics, children with suspected coeliac disease are investigated by small bowel biopsy both at presentation and follow‐up while on a gluten‐free diet. Eighteen (40%) of the clinics employ a different diagnostic routine for children under 2 y of age than for those older than 2 y. All clinics use coeliac serological testing at various stages of the diagnostic procedure. Conclusion: All Swedish paediatric clinics perform a small bowel biopsy at presentation in children with suspected coeliac disease, and the majority of clinics perform a second biopsy when the child is on a gluten‐free diet. Serological testing is frequently used as a diagnostic aid and in the monitoring of the disease while on a gluten‐free diet.