Questionnaire showed that Swedish paediatric clinics complied well with the revised European guidelines for diagnosing coeliac disease.

Anna Myléus, Lars Stenhammar, Lotta Högberg, Lars Browaldh, Ing-Marie Daniels, Ulrika L Fagerberg, Audur H Gudjónsdóttir, Marianne Malmquist, Olof Sandström, Anneli Ivarsson

Journal: Acta paediatrica (Oslo, Norway : 1992) 2020;108(6):1140-1143

PMID: 30496613

Abstract

AIM

In 2012, revised criteria for diagnosing childhood coeliac disease were published by the European Society for Paediatric Gastroenterology, Hepatology and Nutrition and incorporated into the revised Swedish guidelines the same year. These made it possible, in certain cases, to diagnose coeliac disease without taking small bowel biopsies. This survey assessed the extent to which the new guidelines were implemented by Swedish paediatric clinics two years after their introduction.

METHODS

In October 2014, we distributed a paper questionnaire including five questions on diagnostic routines to the 40 paediatric clinics in university or regional hospitals in Sweden that perform small bowel biopsies.

RESULTS

All 36 (90%) clinics that responded used anti-tissue transglutaminase antibodies as the initial diagnostic test and some also used serological markers. Most clinics (81%) used endoscopy and took multiple duodenal biopsies, whereas only a few (19%) occasionally employed a suction capsule. Almost all clinics (86%) omitted taking small bowel biopsies in symptomatic children with repeatedly high coeliac serology and positive genotyping, thereby avoiding the need for invasive endoscopy under anaesthesia.

CONCLUSION

The 2012 Swedish Paediatric Coeliac Disease Diagnostic Guidelines had been widely accepted and implemented in routine health care two years after their introduction.

©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Address: Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden.; Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden.; Department of Paediatrics and Department of Clinical and Experimental Medicine, Linköping University, Norrköping, Sweden.; Department of Clinical Science and Education, Karolinska Institutet and Paediatric Clinic, Södersjukhuset, Stockholm, Sweden.; Department of Paediatrics, Uppsala University Hospital, Uppsala, Sweden.; Department of Paediatrics, Centre for Clinical Research, Västmanland Hospital, Västerås and Karolinska Institutet, Stockholm, Sweden.; Department of Paediatric Gastroenterology, Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.
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