European Society for Pediatric Gastroenterology, Hepatology, and Nutrition Guidelines for the Diagnosis of Coeliac Disease

摘要: Objective: Diagnostic criteria for coeliac disease (CD) from the European Society Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) were published in 1990. Since then, autoantigen CD, tissue transglutaminase, has been identified; perception of CD changed that a rather uncommon enteropathy to common multiorgan strongly dependent on haplotypes human leukocyte antigen (HLA)-DQ2 HLA-DQ8; CD-specific antibody tests have improved. Methods: A panel 17 experts defined developed new diagnostic based Delphi process. Two groups patients with different approaches diagnose CD: children symptoms suggestive (group 1) asymptomatic at increased risk 2). The 2004 National Institutes Health/ Agency Healthcare Research Quality report systematic literature search paediatric covering years 2009 was basis evidence-based recommendations testing. Results: In group 1, diagnosis is symptoms, positive serology, histology consistent CD. If immunoglobulin anti-tissue transglutaminase type 2 titers are high (>10 times upper limit normal), then option without duodenal biopsies by applying strict protocol further laboratory tests. 2, serology histology. HLADQ2 HLA-DQ8 testing valuable because unlikely if both negative. Conclusions: aim guidelines achieve accuracy reduce burden their families. performance these clinical practice should be evaluated prospectively. (JPGN 2012;54: 136–160)