One Year Outcomes Among Children Identified With Celiac Disease Through A Mass Screening Program.

BACKGROUND

Celiac disease (CD) mass screening remains controversial in part because of a paucity of data to support its benefit. The Autoimmunity Screening for Kids (ASK) study is a mass screening study for pediatric CD and type 1 diabetes in Colorado.

METHODS

This study prospectively follows children ages 1-17 years who screened positive for tissue transglutaminase IgA autoantibodies (tTGA) in the ASK study subsequently referred for diagnostic evaluation. Children diagnosed with CD by biopsy or serologic criteria were included in this study. Evaluation at baseline and 12 month follow up included demographics, laboratory studies, symptoms, health-related quality of life (HRQoL), anxiety/depression, and gluten-free diet (GFD) adherence. Paired student-t, chi-square, and Wilcoxon sign rank tests compared baseline and follow up data. For symptom scores, odds of improvement were assessed.

RESULTS

Of the 52 children with CD enrolled, 42 children completed 12-month follow up. On the symptom questionnaire completed at diagnostic evaluation, 38/42 children reported one or more symptoms. CD mean symptom severity and frequency scores improved from baseline to follow up (p <0.001). Reported HRQoL scores improved among caregivers (p=0.002). There was no significant change in reported anxiety or depression. Iron deficiency without anemia was common at baseline (21/24 children, 87.5%) and normalized at follow up (11/21 children, 52.3%). 26/28 families reported good or excellent GFD adherence.

CONCLUSIONS

This novel study of children with CD identified through a mass screening program demonstrated improvement in symptoms, quality of life, and iron deficiency after one year follow up. This demonstrates that there may be benefit to CD mass screening.

Informations de copyright

Copyright © 2024. Published by Elsevier Inc.