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. 2022 Sep 1;75(3):369-386.
doi: 10.1097/MPG.0000000000003540. Epub 2022 Jun 27.

ESPGHAN Position Paper on Management and Follow-up of Children and Adolescents With Celiac Disease

Maria Luisa Mearin  1 , Daniel Agardh  2   3 , Henedina Antunes  4   5   6 , Abdul Al-Toma  7 , Renata Auricchio  8 , Gemma Castillejo  9 , Carlo Catassi  10 , Carolina Ciacci  11 , Valentina Discepolo  8 , Jernej Dolinsek  12 , Ester Donat  13   14 , Peter Gillett  15 , Steffano Guandalini  16 , Steffen Husby Md DMSc  17 , Sibylle Koletzko Md  18   19 , Tunde Koltai  20 , Ilma Rita Korponay-Szabó  21   22 , Kalle Kurppa  23   24   25 , Elena Lionetti  10 , Karl Mårild  26   27 , Eva Martinez Ojinaga  28 , Caroline Meijer  1 , Chiara Monachesi  10 , Isabel Polanco  28 , Alina Popp  29 , Maria Roca  14 , Alfonso Rodriguez-Herrera  30 , Raanan Shamir  31 , Ketil Stordal  32 , Riccardo Troncone  8 , Francesco Valitutti  33 , Anita Vreugdenhil  34 , Margreet Wessels  35 , Penny Whiting  36 ; ESPGHAN Special Interest Group on Celiac Disease
Affiliations

ESPGHAN Position Paper on Management and Follow-up of Children and Adolescents With Celiac Disease

Maria Luisa Mearin et al. J Pediatr Gastroenterol Nutr. .

Abstract

Objectives: To gather the current evidence and to offer recommendations for follow-up and management.

Methods: The Special Interest Group on Celiac Diseases of the European Society of Paediatric Gastroenterology Hepatology and Nutrition formulated ten questions considered to be essential for follow-up care. A literature search (January 2010-March 2020) was performed in PubMed or Medline. Relevant publications were identified and potentially eligible studies were assessed. Statements and recommendations were developed and discussed by all coauthors. Recommendations were voted upon: joint agreement was set as at least 85%.

Results: Publications (n = 2775) were identified and 164 were included. Using evidence or expert opinion, 37 recommendations were formulated on: The need to perform follow-up, its frequency and what should be assessed, how to assess adherence to the gluten-free diet, when to expect catch-up growth, how to treat anemia, how to approach persistent high serum levels of antibodies against tissue-transglutaminase, the indication to perform biopsies, assessment of quality of life, management of children with unclear diagnosis for which a gluten-challenge is indicated, children with associated type 1 diabetes or IgA deficiency, cases of potential celiac disease, which professionals should perform follow-up, how to improve the communication to patients and their parents/caregivers and transition from pediatric to adult health care.

Conclusions: We offer recommendations to improve follow-up of children and adolescents with celiac disease and highlight gaps that should be investigated to further improve management.

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Conflict of interest statement

Mearin received receipt of grants/research supports from Research Grant Eurospital, ThermoFisher and BioHit and served as member of advisory board and consultancy and speaker from ThermoFisher. Agardh received receipt of grants/research supports from Novo Nordisk Foundation and served as member of advisory board from Takeda and ThermoFischer. Antunes received receipt of payment/honorarium for lectures from Danone, Catassi received receipt of payment/honorarium for consultation from Dr Schar Food. Dolinsek received receipt of payment/honorarium for lectures from Medis, Abbot, Merit. Guandalini served as member of advisory board from ExeGIPharma, Imaware. Koletzko received receipt of grants/research supports from Mead-Johnson, Biogaia; served as member of advisory board from Abbvie, Danone, Jannsen, Sanofi, Takeda; receipt of payment/honorarium for lectures from Danone, Mead-Johnson, Nestlé Nutrition, Pfizer, Takeda; receipt of payment/honorarium for consultation from Danone. Korponay-Szabó other support from patent on celiac disease rapid test licensed to Labsystems Oy, Vantaa, Finland. Kurppa received receipt of grants/research supports from Finnish Pediatric Foundation, Päivikki, and Sakari Sohlberg Foundation; served as member of advisory board from Finnish Coeliac Society; receipt of payment/honorarium for lectures from Thermo Fisher; and receipt of payment/honorarium for consultation from Takeda. Rodriguez-Herrera received other support from Patent and detecting gluten peptides in human fluids, March 29, 2019—Universidad de Sevilla. Shamir received receipt of grants/research supports from Helmsley Foundation; served as member of advisory board: Nestle Nutrition Institute, Teva; receipt of payment/honorarium for lectures from Abbott, Nutricia, Nestle Nutrition Institute; receipt of payment/honorarium for consultation from Abbott, Else, Nutricia, Nestle Nutrition Institute and Stock shareholder from NGS. Ciacci received receipt of honoraria or consultation fees from Takeda, GSK, Mediserve, Biogen Celltrion. The remaining authors report no conflicts of interest.

References

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