Spanish National Registry of Paediatric Coeliac Disease: Changes in the Clinical Presentation in the 21st Century.

Autor: Pérez Solís D; Department of Paediatrics, Hospital Universitario San Agustín, Aviles., Cilleruelo Pascual ML; Department of Paediatrics, Hospital Universitario Puerta de Hierro, Majadahonda., Ochoa Sangrador C; Department ofPaediatrics, Hospital Virgen de la Concha, Zamora., García Burriel JI; Department of Paediatrics, Complejo Hospitalario Universitario de Vigo, Vigo., Sánchez-Valverde Visus F; Department of Paediatrics, Complejo Hospitalario de Navarra, Pamplona., Eizaguirre Arocena FJ; Department of Paediatrics, Hospital Universitario Donostia, Donostia - San Sebastian., Garcia Calatayud S; Department of Paediatrics, Hospital Universitario Marqués de Valdecilla, Santander., Martinez-Ojinaga Nodal E; Department of Paediatric Gastroenterology and Nutrition, Hospital Universitario La Paz, Madrid., Donat Aliaga E; Department of Paediatric Gastroenterology, Hepatology and Nutrition, Hospital Universitario y Politecnico La Fe, Valencia., Barrio Torres J; Department of Paediatrics, Hospital Universitario de Fuenlabrada, Fuenlabrada., Castillejo de Villasante G; Depart-Department of Paediatrics, Hospital Universitari Sant Joan de Reus, Reus., Miranda Cid MDC; Department of Paediatrics, Hospital Universitario Infanta Cristina, Parla., Torres Peral R; Department of Paediatrics, Hospital Universitario de Salamanca, Salamanca., Vecino Lopez R; Department of Paediatrics, Hospital Clinico San Carlos, Madrid., Juste Ruiz M; Department of Paediatrics, Hospital Universitario San Juan de Alicante, Alicante., Armas Ramos H; Department of Paediatrics, Hospital Universitario de Canarias, Santa Cruz de Tenerife., Barros Garcia P; Department of Paediatrics, Hospital San Pedro de Alcantara, Caceres., Leis Trabazo R; Department of Paediatrics, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela., Solaguren Alberdi R; Department of Paediatrics, Complejo Hospitalario Universitario de Toledo, Toledo., Salazar Quero JC; Depart-Department of Paediatrics, Hospital Universitario Infantil Virgen del Rocio, Sevilla., Garcia Romero R; Department of Paediatrics, Hospital Materno Infantil Miguel Servet, Zaragoza., Ortigosa Del Clastillo L; Department of Paediatrics, Hospital Universitario Virgen de la Candelaria, Santa Cruz de Tenerife., Peña Quintana L; Department of Paediatrics, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria., Urruzuno Telleria P; Department of Paediatrics, Hospital Universitario Doce de Octubre, Madrid., Codoñer Franch P; Department of Paediatrics, Hospital Universitario Dr. Peset, Valencia., Garcia Casales Z; Department of Paediatrics, Hospital Universitario de Araba - Txagorritxu, Vitoria., Masiques Mas ML; Department of Paediatrics, Hospital General de Granollers, Granollers., Galicia Poblet G; Department of Paediatrics, Hospital Universitario de Guadalajara, Guadalajara., Martinez Costa C; Department of Paediatrics, Hospital Clinico Universitario de Valencia, Valencia., Balmaseda Serrano E; Department of Paediatrics, Complejo Hospitalario Universitario de Albacete, Albacete, Spain., Polanco Allué I; Department of Paediatric Gastroenterology and Nutrition, Hospital Universitario La Paz, Madrid., Ribes Koninck C; Department of Paediatrics, Complejo Hospitalario Universitario de Toledo, Toledo., Román Riechmann E; Department of Paediatrics, Hospital Universitario Puerta de Hierro, Majadahonda.
Jazyk: angličtina
Zdroj: Journal of pediatric gastroenterology and nutrition [J Pediatr Gastroenterol Nutr] 2022 Jun 01; Vol. 74 (6), pp. 805-811. Date of Electronic Publication: 2022 Mar 02.
DOI: 10.1097/MPG.0000000000003424
Abstrakt: Objectives: Over the last several decades, there has been a tendency towards a predominance of less symptomatic forms of coeliac disease (CD) and an increase in the patient age at diagnosis. This study aimed to assess the clinical presentation and diagnostic process of paediatric CD in Spain.
Methods: A nationwide prospective, observational, multicentre registry of new paediatric CD cases was conducted from January 2011 to June 2017. The data regarding demographic variables, type of birth, breast-feeding history, family history of CD, symptoms, height and weight, associated conditions, serological markers, human leukocyte antigen (HLA) phenotype, and histopathological findings were collected.
Results: In total, 4838 cases (61% girls) from 73 centres were registered. The median age at diagnosis was 4 years. Gastrointestinal symptoms were detected in 71.4% of the patients, and diarrhoea was the most frequent symptom (45.9%). The most common clinical presentation was the classical form (65.1%) whereas 9.8% ofthe patients were asymptomatic. There was a trend towards an increase in the age at diagnosis, proportion of asymptomatic CD cases, and usage of anti-deamidated gliadin peptide antibodies and HLA typing for CD diagnosis. There was, however, a decreasing trend in the proportion of patients undergoing biopsies. Some of these significant trend changes may reflect the effects of the 2012 ESPGHAN diagnosis guidelines.
Conclusions: Paediatric CD in Spain is evolving in the same direction as in the rest of Europe, although classical CD remains the most common presentation form, and the age at diagnosis remains relatively low.
Competing Interests: The authors report no conflicts of interest.
(Copyright © 2022 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.)
Databáze: MEDLINE
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