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Have serological tests changed the face of childhood coeliac disease? A retrospective cohort study

OBJECTIVES: The aim of this study was to evaluate if the use of antitransglutaminase (tTG) and antiendomysium (EM) antibodies has modified the profile of coeliac disease (CD) in children. DESIGN: Retrospective cohort study. SETTING: Monocentric study, in one major tertiary centre in Paris. Two cohor...

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Autores principales: Garnier-Lengliné, Hélène, Brousse, Nicole, Candon, Sophie, Goulet, Olivier, Ruemmele, Frank M, Schmitz, Jacques
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3532964/
https://www.ncbi.nlm.nih.gov/pubmed/23180388
http://dx.doi.org/10.1136/bmjopen-2012-001385
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author Garnier-Lengliné, Hélène
Brousse, Nicole
Candon, Sophie
Goulet, Olivier
Ruemmele, Frank M
Schmitz, Jacques
author_facet Garnier-Lengliné, Hélène
Brousse, Nicole
Candon, Sophie
Goulet, Olivier
Ruemmele, Frank M
Schmitz, Jacques
author_sort Garnier-Lengliné, Hélène
collection PubMed
description OBJECTIVES: The aim of this study was to evaluate if the use of antitransglutaminase (tTG) and antiendomysium (EM) antibodies has modified the profile of coeliac disease (CD) in children. DESIGN: Retrospective cohort study. SETTING: Monocentric study, in one major tertiary centre in Paris. Two cohorts of patients were compared; the first included patients before the use of antibodies, and the second included patients after the use of antibodies. PARTICIPANTS: All patients from the same physician diagnosed with a CD between 1976 and 1992 (historical cohort), and between 1994 and 2007, were included in the study. 56 patients were included in the historical cohort, 59 in the recent cohort. PRIMARY AND SECONDARY OUTCOME MEASURES: Clinical, biological and histological profiles at diagnosis have been studied. RESULTS: The recent cohort diagnosis of CD was based in 27% on a systematic screening (type I diabetes, n=10; CD in siblings, n=6). On comparison of CD patients in the historical to the recent cohort, the following significant differences were observed: Median age at diagnosis increased from 1 year to 2.7 years (p<0.0001). Patients in the historical cohort had more gastrointestinal symptoms (93% vs 63%, p=0.0001) and failure to thrive (98% vs 80%, p=0.0025). Nutritional deficiencies and morphological lesions were more severe in the historical cohort (90% subtotal or total villous atrophy vs 51%, p<0.0001). Differences observed between the two cohorts were mainly due to the presence of screened patients. CONCLUSIONS: A new type of patients, with a paucisymptomatic or asymptomatic CD, has been identified using serological tests. Silent disease has been diagnosed by screening in a target population. In the other patients of the recent cohort, symptoms were similar but less severe than those observed before. Long-term risks of untreated silent CD are not well determined as yet, and have to be evaluated in prospective studies.
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spelling pubmed-35329642013-01-04 Have serological tests changed the face of childhood coeliac disease? A retrospective cohort study Garnier-Lengliné, Hélène Brousse, Nicole Candon, Sophie Goulet, Olivier Ruemmele, Frank M Schmitz, Jacques BMJ Open Paediatrics OBJECTIVES: The aim of this study was to evaluate if the use of antitransglutaminase (tTG) and antiendomysium (EM) antibodies has modified the profile of coeliac disease (CD) in children. DESIGN: Retrospective cohort study. SETTING: Monocentric study, in one major tertiary centre in Paris. Two cohorts of patients were compared; the first included patients before the use of antibodies, and the second included patients after the use of antibodies. PARTICIPANTS: All patients from the same physician diagnosed with a CD between 1976 and 1992 (historical cohort), and between 1994 and 2007, were included in the study. 56 patients were included in the historical cohort, 59 in the recent cohort. PRIMARY AND SECONDARY OUTCOME MEASURES: Clinical, biological and histological profiles at diagnosis have been studied. RESULTS: The recent cohort diagnosis of CD was based in 27% on a systematic screening (type I diabetes, n=10; CD in siblings, n=6). On comparison of CD patients in the historical to the recent cohort, the following significant differences were observed: Median age at diagnosis increased from 1 year to 2.7 years (p<0.0001). Patients in the historical cohort had more gastrointestinal symptoms (93% vs 63%, p=0.0001) and failure to thrive (98% vs 80%, p=0.0025). Nutritional deficiencies and morphological lesions were more severe in the historical cohort (90% subtotal or total villous atrophy vs 51%, p<0.0001). Differences observed between the two cohorts were mainly due to the presence of screened patients. CONCLUSIONS: A new type of patients, with a paucisymptomatic or asymptomatic CD, has been identified using serological tests. Silent disease has been diagnosed by screening in a target population. In the other patients of the recent cohort, symptoms were similar but less severe than those observed before. Long-term risks of untreated silent CD are not well determined as yet, and have to be evaluated in prospective studies. BMJ Publishing Group 2012-11-22 /pmc/articles/PMC3532964/ /pubmed/23180388 http://dx.doi.org/10.1136/bmjopen-2012-001385 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.
spellingShingle Paediatrics
Garnier-Lengliné, Hélène
Brousse, Nicole
Candon, Sophie
Goulet, Olivier
Ruemmele, Frank M
Schmitz, Jacques
Have serological tests changed the face of childhood coeliac disease? A retrospective cohort study
title Have serological tests changed the face of childhood coeliac disease? A retrospective cohort study
title_full Have serological tests changed the face of childhood coeliac disease? A retrospective cohort study
title_fullStr Have serological tests changed the face of childhood coeliac disease? A retrospective cohort study
title_full_unstemmed Have serological tests changed the face of childhood coeliac disease? A retrospective cohort study
title_short Have serological tests changed the face of childhood coeliac disease? A retrospective cohort study
title_sort have serological tests changed the face of childhood coeliac disease? a retrospective cohort study
topic Paediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3532964/
https://www.ncbi.nlm.nih.gov/pubmed/23180388
http://dx.doi.org/10.1136/bmjopen-2012-001385
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