title: Burden of illness in screen-detected children with celiac disease and their families.
abstract: OBJECTIVE
  Because of a variable clinical picture, most children with celiac disease remain unrecognized without active serologic screening. Because, however, many patients are asymptomatic, the justification for screening remains unclear. We assessed health and well-being and the effect of a 1-year gluten-free diet in a nationwide cohort of children with celiac disease detected by screening in at-risk groups.
  
  
  METHODS
  A total of 222 newly detected children received a validated questionnaire covering aspects of the burden caused by the undiagnosed celiac disease. After 1 year, adherence to the diet and difficulties attending this, attitudes toward and effects of disease and diet on daily life, and parents' satisfaction with the diagnosis were inquired about. The children's health and parents' concern for it were asked about at diagnosis and on treatment. The outcomes of screen-detected children were compared with those of children diagnosed on the basis of clinical symptoms.
  
  
  RESULTS
  Forty-three screen-detected and 88 symptom-detected children responded. Also, 65% of the screen-detected patients experienced symptoms; these, however, being less troublesome and of shorter duration than in symptom-detected subjects. There were no differences between the groups in dietary adherence (71% vs 84% strict diet), management of the diet (80% vs 80%), alleviation of symptoms (78% vs 86%), and improvement in daily life (73% vs 69%), or in satisfaction with the diagnosis (93% vs 88%). Improved health and reduced parental concern were observed in both groups.
  
  
  CONCLUSIONS
  Screen-detected children with celiac disease can attain satisfactory dietary adherence and benefit from treatment similarly to symptom-detected patients. The results support intensified screening for celiac disease in at-risk children.
authors.affiliation: School of Medicine, University of Tampere, Tampere, Finland.
authors.forename: Sampsa
authors.initials: S
authors.lastname: Kinos
authors.forename: Kalle
authors.initials: K
authors.lastname: Kurppa
authors.forename: Anniina
authors.initials: A
authors.lastname: Ukkola
authors.forename: Pekka
authors.initials: P
authors.lastname: Collin
authors.forename: Marja-Leena
authors.initials: ML
authors.lastname: Lähdeaho
authors.forename: Heini
authors.initials: H
authors.lastname: Huhtala
authors.forename: Leila
authors.initials: L
authors.lastname: Kekkonen
authors.forename: Markku
authors.initials: M
authors.lastname: Mäki
authors.forename: Katri
authors.initials: K
authors.lastname: Kaukinen
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D001294:Attitude to Health; D002446:Celiac Disease / Q000150:complications / Q000175:diagnosis / Q000178:diet therapy; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D017281:Cost of Illness; D055050:Diet, Gluten-Free; D005260:Female; D006262:Health; D006801:Humans; D007223:Infant; D008297:Male; D008403:Mass Screening; D010290:Parents; D010349:Patient Compliance; D017060:Patient Satisfaction; D011795:Surveys and Questionnaires