title: ESPGHAN 2012 Guidelines for Coeliac Disease Diagnosis: Validation Through a Retrospective Spanish Multicentric Study.
abstract: OBJECTIVE
  A large retrospective multicentre study was conducted in Spain to evaluate the efficiency of the new European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) criteria for the diagnosis of coeliac disease (CD).
  
  
  METHODS
  The study protocol was approved by the ethics committee of Hospital Universitari i Politècnic La Fe (Valencia, Spain). The present study included 2177 children (ages 0.6-15.9 years) with small bowel biopsy (SBB) performed for diagnostic purposes (from 2000 to 2009) and with a minimum 2-year follow-up after biopsy.
  
  
  RESULTS
  CD was diagnosed in 2126 patients (97.5%) and excluded in 51 (2.5%). Tissue transglutaminase antibodies (TG2A), anti-endomysial antibodies (EMA), and human leukocyte antigen (HLA) were reported in 751 patients, 640 symptomatic and 111 asymptomatic. TG2A levels >10 times the upper limit of normal, plus positive EMA and HLA DQ2 and/or DQ8 haplotypes, were found in 336 symptomatic patients, all of them with final diagnosis of CD. In 65 of 69 asymptomatic patients, 65 had confirmed CD and 4 did not have CD. According to the 2012 ESPGHAN guidelines, SBB may have been omitted in 52% of the symptomatic patients with CD with serologic and HLA available data. Gluten challenge was performed in 158 children, 75 of them <2 years at first biopsy. Only 1 patient in whom according to the new proposed diagnostic criteria gluten challenge would not have been mandatory did not relapse.
  
  
  CONCLUSIONS
  Our results support the new ESPGHAN 2012 guidelines for diagnosis of CD can be safely used without the risk of overdiagnosis. A prospective multicentre study is needed to confirm our results.
authors.affiliation: *Pediatric Gastroenterology, Hepatology and Nutrition, Hospital Universitari i Politècnic La Fe, Valencia †Pediatric Gastroenterology, Complejo Hospitalario Universitario de Vigo, Vigo ‡Pediatric Gastroenterology, Hospital Virgen del Camino, Pamplona §Pediatric Gastroenterology and Nutrtion, Hospital Teresa Herrrera, A Coruña ||Pediatric Gastroenterology, Hospital Universitario Niño Jesus, Madrid ¶Pediatric Gastroenterology, Hepatology and Nutrition Unit, Pediatrics Department, Hospital Clínico Universitario de Santiago, Pediatrics Nutrition Research Group-IDIS, Universidad de Santiago de Compostela, Santiago de Compostela #Pediatric Gastroenterology and Nutrition Unit, Hospital Materno-Infantil, Universidad de Las Palmas de Gran Canaria, Las Palmas and CIBER OBN ††Pediatric Gastroenterology, Hospital Universitari de Sant Joan de Reus, Reus ‡‡Pediatric Gastroenterology, Hospital Severo Ochoa, Madrid §§Pediatric Gastroenterology, Hospital de Txagorritxu, Vitoria ||||Pediatric Gastroenterology, Hospital Universitario Ntra Sra de Candelaria, Tenerife ¶¶Pediatric Gastroenterology, Hospital General de Albacete, Albacete ##Pediatric Gastroenterology, Hospital Clínico Universitario de Valladolid, Valladolid ***Pediatric Gastroenterology Unit, Hospital Donostia, San Sebastian †††Pediatric Gastroenterology, Hospital Universitario de Basurto, Bilbao ‡‡‡Pediatric Gastroenterology, Hospital Universitario de Fuenlabrada, Madrid §§§Pediatric Gastroenterology, Hepatology and Nutrition, Hospital Universitari i Politècnic La Fe, Valencia, Spain.
authors.forename: Ester
authors.initials: E
authors.lastname: Donat
authors.forename: Jose M
authors.initials: JM
authors.lastname: Ramos
authors.forename: Félix
authors.initials: F
authors.lastname: Sánchez-Valverde
authors.forename: Ana
authors.initials: A
authors.lastname: Moreno
authors.forename: Maria-Jose
authors.initials: MJ
authors.lastname: Martinez
authors.forename: Rosaura
authors.initials: R
authors.lastname: Leis
authors.forename: Luis
authors.initials: L
authors.lastname: Peña-Quintana
authors.forename: Gemma
authors.initials: G
authors.lastname: Castillejo
authors.forename: Sonia
authors.initials: S
authors.lastname: Fernández
authors.forename: Zuriñe
authors.initials: Z
authors.lastname: Garcia
authors.forename: Luis
authors.initials: L
authors.lastname: Ortigosa
authors.forename: Elena
authors.initials: E
authors.lastname: Balmaseda
authors.forename: José-Manuel
authors.initials: JM
authors.lastname: Marugán
authors.forename: Francisco-Javier
authors.initials: FJ
authors.lastname: Eizaguirre
authors.forename: Helena
authors.initials: H
authors.lastname: Lorenzo
authors.forename: Josefa
authors.initials: J
authors.lastname: Barrio
authors.forename: Carmen
authors.initials: C
authors.lastname: Ribes-Koninckx
mesh_terms: D000293:Adolescent; D000906:Antibodies / Q000378:metabolism*; D001706:Biopsy; D002446:Celiac Disease / Q000175:diagnosis* / Q000235:genetics / Q000276:immunology / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D004032:Diet; D005983:Glutens / Q000276:immunology*; D006680:HLA Antigens / Q000235:genetics*; D006801:Humans; D007223:Infant; D007421:Intestine, Small / Q000378:metabolism / Q000473:pathology*; D017410:Practice Guidelines as Topic; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012955:Societies, Medical; D013030:Spain
chemical_list: D000906:Antibodies; D006680:HLA Antigens; D005983:Glutens