Usefulness of Symptoms to Screen for Celiac Disease
2014 (English)In: Pediatrics, ISSN 0031-4005, Vol. 133, no 2, 211-218 p.Article in journal (Refereed) Published
OBJECTIVE: To describe the frequency of symptoms and associated conditions among screening-detected celiac disease (CD) cases and non-CD children and to evaluate questionnaire-based case-finding targeting the general population. METHODS: In a population-based CD screening of 12-year-olds, children and their parents completed questionnaires on CD-associated symptoms and conditions before knowledge of CD status. Questionnaire data for those who had their CD detected in the screening (n = 153) were compared with those of children with normal levels of CD markers (n = 7016). Hypothetical case-finding strategies were also evaluated. Questionnaires were returned by 7054 ( 98%) of the children and by 6294 ( 88%) of their parents. RESULTS: Symptoms were as common among screening-detected CD cases as among non-CD children. The frequency of children with screening-detected CD was similar when comparing the groups with and without any CD-related symptoms (2.1% vs 2.1%; P =.930) or CD-associated conditions (3.6% vs 2.1%; P =.07). Case-finding by asking for CD-associated symptoms and/or conditions would have identified 52 cases (38% of all cases) at a cost of analyzing blood samples for 2282 children (37%) in the study population. CONCLUSIONS: The current recommended guidelines for finding undiagnosed CD cases, so-called active case-finding, fail to identify the majority of previously undiagnosed cases if applied in the general population of Swedish 12- year-olds. Our results warrant further studies on the effectiveness of CD case-finding in the pediatric population, both at the clinical and population-based levels.
Place, publisher, year, edition, pages
American Academy of Pediatrics , 2014. Vol. 133, no 2, 211-218 p.
case-finding; celiac disease; questionnaire; screening; symptom
IdentifiersURN: urn:nbn:se:liu:diva-107468DOI: 10.1542/peds.2012-3765ISI: 000333413600006OAI: oai:DiVA.org:liu-107468DiVA: diva2:724278