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Celiachia senza biopsia: dalle parole ai fatti
Diagnosis of coeliac disease without biopsy: from theory to practice
E. Benelli, V. Carrato, S. Martelossi, L. Ronfani, T. Not, A. Ventura
Marzo 2016 - pagg. 159 -176
Abstract
The aim of the present prospective study is to evaluate the clinical consequences of the
last ESPGHAN and BSPGHAN guidelines for the diagnosis of Coeliac Disease (CD). All
children (aged 0-18 years) diagnosed with CD from January 2011 to May 2014 at the
IRCCS Burlo Garofolo of Trieste (Italy) were prospectively enrolled. Children diagnosed
without a duodenal biopsy (Group 1) were matched for sex, age, and year of diagnosis
to a sample of children diagnosed with a duodenal biopsy (Group 2). All patients were
put on Gluten Free Diet (GFD) and followed-up for clinical condition, BMI, and laboratory
tests (haemoglobin, serum anti-transglutaminase IgA antibodies) at six months and
every year since diagnosis (median follow-up: 1.9 years). Adherence to GFD and quality
of life of children were assessed through validated questionnaires. 51 out of 468 (11%)
patients were diagnosed without a duodenal biopsy (Group 1; median age 2.1 years)
and matched to 92 patients diagnosed with a biopsy (Group 2; median age 2.4 years).
At the end of the follow-up the two groups resulted statistically comparable for clinical
and nutritional status, serum anti-transglutaminase IgA antibodies titres, quality of life, adherence
to GFD, and number of supplementary post-diagnosis medical consultations. The
diagnosis of CD can be safely performed without a duodenal biopsy at least in 11% of
cases. At least during a medium-term follow-up, this approach has no negative consequence
on clinical remission, adherence to diet, and quality of children’s lives.
Classificazione MeSH
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Corrispondenza: elisa.benelli@gmail.com