☆ 4.5 Review

Celiac Disease in Children: A 2023 Update

INDIAN JOURNAL OF PEDIATRICS (2023)

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Systematic review with meta-analysis: the accuracy of serological tests to support the diagnosis of coeliac disease

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Review article: Therapeutic targets for the pharmacologic management of coeliac disease-The future beyond a gluten-free diet

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Summary: This article reviews the current and upcoming clinical trial programs for pharmacologic agents for CeD, aiming to provide more treatment options. By studying the pathophysiology of CeD, evaluating the evidence supporting existing and future drug targets, and highlighting unique considerations for conducting CeD trials, it aims to accurately appraise the evidence and outline the potential future of CeD therapy.

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Sources of dietary gluten in the first 2 years of life and associations with celiac disease autoimmunity and celiac disease in Swedish genetically predisposed children: The Environmental Determinants of Diabetes in the Young (TEDDY) study

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Summary: High dietary intake of gluten is associated with increased risk of celiac disease (CD) in children at genetic risk. Intake of high amounts of bread and milk cereal drink before the age of 2 is associated with increased risk of both celiac disease autoimmunity (CDA) and CD in genetically at-risk children.

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Summary: This study found that children with CD-FDR develop celiac disease early in life, and their risk depends on gender, age, and HLA-DQ. Therefore, screening for celiac disease in these children should be done early, including HLA-DQ2/8 typing, and further personalized screening advice should be provided.

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Summary: Coeliac disease is an immune-mediated disease caused by gluten ingestion, impacting not only Europeans but also people worldwide. The prevalence and incidence of coeliac disease have increased over the past three decades, potentially due to improved diagnostic methods, dietary changes, and increased awareness. In addition to genetic factors, early-life gluten intake has been shown to increase the risk of the disease.

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Summary: A consensus is needed for the follow-up recommendations of children and adolescents with celiac disease. This study gathered current evidence and formulated 37 recommendations on various aspects of follow-up care, including treatment, growth, blood testing, and biopsy. The aim is to improve the follow-up management of children with celiac disease and identify areas for further research.

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Diagnosis of celiac disease is being missed in over 80% of children particularly in those from socioeconomically deprived backgrounds

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Summary: This study aimed to investigate the differences in diagnosis rates of CD in children from different socioeconomic groups and found that while the diagnosed incidence of CD has increased over time, 83-91% remain undiagnosed. Children from socioeconomically deprived backgrounds are more likely to be underdiagnosed, and the gap between the least and most deprived has widened. To address the massive underdiagnosis, further strategies, including pilot studies using finger prick serological mass screening for CD in children entering primary schools, are needed.

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EUROPEAN JOURNAL OF PEDIATRICS (2021)

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Editorial Material Gastroenterology & Hepatology

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