title: Applicability of the New ESPGHAN Guidelines for Diagnosing Coeliac Disease in Children from Resource Limited Countries.
abstract: Coeliac Disease (CD) is an immune-mediated systemic disorder elicited by the ingestion of gluten. Small-bowel biopsies and histology has been the gold standard for diagnosing CD. The modified ESPGHAN guidelines recommend that in symptomatic children with anti-tissue-Transglutaminase (tTG) titre of > 10 times Upper-Limit-of-Normal (ULN), diagnosis of CD can be made without small-bowel biopsies. However, positive HLA-DQ2/DQ8 serotype and anti-Endomysial Antibodies (EMA) are necessary. Studies from resource-limited countries have demonstrated applicability of the ESPGHAN guidelines for serological diagnosis of CD. CD should not be diagnosed on the basis of a single high tTG-titre. Small-bowel biopsies are necessary for diagnosing CD in asymptomatic children and those with tTG-titre < 10 x ULN. Management of CD needs lifelong gluten free diet.
authors.affiliation: Department of Paediatric Gastroenterology, Bristol Royal Hospital for Children, Paul O'Gorman Building, Upper Maudlin Street, Bristol BS2 8BJ, UK.
authors.forename: Siba Prosad
authors.initials: SP
authors.lastname: Paul
authors.affiliation: Department of Paediatric Gastroenterology, Bristol Royal Hospital for Children, Paul O'Gorman Building, Upper Maudlin Street, Bristol BS2 8BJ, UK.
authors.forename: Huma
authors.initials: H
authors.lastname: Mazhar
authors.affiliation: Department of Paediatric Gastroenterology, Bristol Royal Hospital for Children, Paul O'Gorman Building, Upper Maudlin Street, Bristol BS2 8BJ, UK.
authors.forename: Christine Helen
authors.initials: CH
authors.lastname: Spray
mesh_terms: D001323:Autoantibodies / Q000276:immunology; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D002446:Celiac Disease / Q000097:blood / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D002648:Child; D005260:Female; D005983:Glutens / Q000276:immunology; D006683:HLA-DQ Antigens / Q000097:blood*; D006801:Humans; D007421:Intestine, Small / Q000473:pathology*; D008297:Male; D010154:Pakistan; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D011503:Transglutaminases / Q000276:immunology*
chemical_list: D001323:Autoantibodies; D015415:Biomarkers; D006683:HLA-DQ Antigens; C109756:HLA-DQ8 antigen; D005983:Glutens; D011503:Transglutaminases