1
|
Bierła JB, Szaflarska-Popławska A, Grzybowska-Chlebowczyk U, Oralewska B, Cyba M, Oracz G, Konopka E, Cukrowska B, Syczewska M, Kołodziejczyk H, Rižnik P, Dolinšek J. Diagnosis, Clinical Presentation and Management of Celiac Disease in Children and Adolescents in Poland. J Clin Med 2024; 13:765. [PMID: 38337459 PMCID: PMC10856589 DOI: 10.3390/jcm13030765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/25/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024] Open
Abstract
Celiac disease (CD) is a chronic immune-mediated disorder triggered by the ingestion of gluten in genetically predisposed individuals, affecting about 1% of the general population in the developed world. In 2012, the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) recommendations for CD diagnoses in children and adolescents were introduced, allowing the "no-biopsy" approach if certain criteria were met. This approach was also confirmed in the revised guidelines published in 2020. Thus, the aim of this study was to assess-over a one-year period-the clinical presentations and current status of the management of children and adolescents diagnosed with CD in Poland. Medical records of children and adolescents, newly diagnosed with CD in 2022/2023 in three medical centers in Poland, were involved. Gastroenterologists completed the specific anonymous web-based forms developed in the CD SKILLS project, including data routinely assessed at individual visits about the diagnostic approach and clinical presentation of the disease. Our study assessed 100 patients (56% girls) with an age range 1.6-18.0 years. We found that 98% of patients were serologically tested prior to a CD diagnosis and 58% of patients were diagnosed using the "no-biopsy" approach. In the analyzed group, 40% belonged to a known risk group, only 22% had annual screening before the CD diagnosis (the longest for 9 years), and 19% showed no symptoms at the time of the CD diagnosis. Our research confirmed the applicability of the "no-biopsy" approach for the diagnosis of CD in children and adolescents in Poland, and also showed changes in the clinical picture of CD. Moreover, we highlight the need to introduce broad CD serological screening in risk groups of the Polish population.
Collapse
Affiliation(s)
- Joanna B. Bierła
- Department of Pathomorphology, The Children’s Memorial Health Institute, Aleja Dzieci Polskich 20, 04-730 Warszawa, Poland; (E.K.); (B.C.)
| | - Anna Szaflarska-Popławska
- Department of Paediatric Endoscopy and Gastrointestinal Function Testing, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Bydgoszcz, 87-100 Toruń, Poland;
| | - Urszula Grzybowska-Chlebowczyk
- Department of Pediatrics, Faculty of Medical Sciences, Medical University of Silesia in Katowice, 40-055 Katowice, Poland;
| | - Beata Oralewska
- Department of Gastroenterology, Hepatology, Nutritional Disorders and Pediatrics, The Children’s Memorial Health Institute, Aleja Dzieci Polskich 20, 04-730 Warsaw, Poland; (B.O.); (M.C.); (G.O.)
| | - Marta Cyba
- Department of Gastroenterology, Hepatology, Nutritional Disorders and Pediatrics, The Children’s Memorial Health Institute, Aleja Dzieci Polskich 20, 04-730 Warsaw, Poland; (B.O.); (M.C.); (G.O.)
| | - Grzegorz Oracz
- Department of Gastroenterology, Hepatology, Nutritional Disorders and Pediatrics, The Children’s Memorial Health Institute, Aleja Dzieci Polskich 20, 04-730 Warsaw, Poland; (B.O.); (M.C.); (G.O.)
| | - Ewa Konopka
- Department of Pathomorphology, The Children’s Memorial Health Institute, Aleja Dzieci Polskich 20, 04-730 Warszawa, Poland; (E.K.); (B.C.)
| | - Bożena Cukrowska
- Department of Pathomorphology, The Children’s Memorial Health Institute, Aleja Dzieci Polskich 20, 04-730 Warszawa, Poland; (E.K.); (B.C.)
| | - Małgorzata Syczewska
- Department of Paediatric Rehabilitation, The Children’s Memorial Health Institute, Aleja Dzieci Polskich 20, 04-730 Warszawa, Poland;
| | - Honorata Kołodziejczyk
- Laboratory of Anthropology, The Children’s Memorial Health Institute, Aleja Dzieci Polskich 20, 04-730 Warszawa, Poland;
| | - Petra Rižnik
- Hepatology and Nutrition Unit, Gastroenterology, Paediatric Department, University Medical Centre Maribor, 2000 Maribor, Slovenia; (P.R.); (J.D.)
| | - Jernej Dolinšek
- Hepatology and Nutrition Unit, Gastroenterology, Paediatric Department, University Medical Centre Maribor, 2000 Maribor, Slovenia; (P.R.); (J.D.)
- Paediatric Department, Faculty of Medicine, University of Maribor, 2000 Maribor, Slovenia
| |
Collapse
|