Spanish National Registry of Paediatric Coeliac Disease: Changes in the Clinical Presentation in the 21st Century
Por:
Solís DP, Pascual MLC, Sangrador CO, Burriel JIG, Visus FS, Arocena FJE, Calatayud SG, Nodal EM, Aliaga ED, Torres JB, de Villasante GC, Cid MDCM, Peral RT, López RV, Ruiz MJ, Ramos HA, García PB, Trabazo RL, Alberdi RS, Quero JCS, Romero RG, Del Castillo LO, Quintana LP, Tellería PU, Franch PC, Casales ZG, Mas MLM, Poblet GG, Costa CM, Serrano EB, Allué IP, Koninck CR and Riechmann ER
Publicada:
1 jun 2022
Ahead of Print:
2 mar 2022
Resumen:
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.
Filiaciones:
Solís DP:
Hospital Universitario San Agustín. Avilés, Spain Hospital Universitario Puerta de Hierro. Majadahonda, Spain Hospital Virgen de la Concha. Zamora, Spain Complejo Hospitalario Universitario de Vigo. Vigo, Spain Complejo Hospitalario de Navarra. Pamplona, Spain Hospital Universitario Donostia. Donostia - San Sebastián, Spain Hospital Universitario Marqués de Valdecilla. Santander, Spain Hospital Universitario La Paz. Madrid, Spain Hospital Universitario y Politécnico La Fe. Valencia, Spain
Pediatría, Hospital General Universitario de Elche, Elx, Alicante (Spain)
HOSP. UNIV. SANT JOAN D'ALACANT - PEDIATRÍA, Sant Joan d'Alacant, Spain
HOSP. UNIV. DR. PESET - PEDIATRÍA, Valencia, Spain
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