Clinical presentation and factors associated with gluten exposure in children with celiac disease.
epidemiology
self‐management
treatment adherence and compliance
Journal
Journal of pediatric gastroenterology and nutrition
ISSN: 1536-4801
Titre abrégé: J Pediatr Gastroenterol Nutr
Pays: United States
ID NLM: 8211545
Informations de publication
Date de publication:
16 Aug 2024
16 Aug 2024
Historique:
revised:
17
05
2024
received:
31
01
2024
accepted:
22
06
2024
medline:
16
8
2024
pubmed:
16
8
2024
entrez:
16
8
2024
Statut:
aheadofprint
Résumé
The prevalence of celiac disease (CeD) is increasing, yet it is still underdiagnosed, in part because of its heterogeneous presentation. Diagnostic criteria are evolving and management with strict adherence to a gluten-free diet is challenging for many. We aimed to characterize the clinical presentation of CeD among a large multicenter cohort of pediatric patients and to identify factors associated with gluten-free diet adherence. Patients with CeD aged 0-18 years were recruited from 11 United States health centers. Parents completed surveys about gluten-free diet adherence and patient electronic health records were reviewed. Logistic regression analyses were performed to identify risk factors associated with gluten exposure. Charts were reviewed for 460 children with a median age of 6.4 years. Abdominal pain was reported in 57% of the cohort, but diverse symptoms were identified. Parent surveys were completed for 455 participants. Sixty-five (14%) participants were at high risk for gluten exposure based on parental reports of weekly or daily gluten exposure or eating gluten by choice in the past year. Participants under the age of 5 years had a lower risk of gluten exposure, while participants without repeat serology testing 18 months after initial diagnosis were at higher risk of gluten exposure. In a large, multicenter cohort of pediatric CeD patients, clinical presentation is highly variable, necessitating a high index of suspicion to make a diagnosis. Parent surveys indicate that 14% of patients are at high risk of gluten exposure, with patient age and lack of close follow-up associated with gluten-free diet adherence.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health
ID : K23DK122127(MML)
Organisme : National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health
ID : K23DK119584(JAS)
Investigateurs
Arunjot Singh
(A)
Bradley Cutter
(B)
Camila Khorrami
(C)
Catherine Raber
(C)
Edwin Liu
(E)
Elizabeth Gleeson
(E)
Kat V Adams
(KV)
Lauren Johnson
(L)
Ling Fan
(L)
Lydia Ramharack
(L)
Madeline Ford
(M)
Marisa G Stahl
(MG)
Meghan Landry
(M)
Monique Germone
(M)
Mason Nuding
(M)
Pooja Mehta
(P)
Rachel Andrews
(R)
Supriya Behl
(S)
Taylor Morson
(T)
Tracy Ediger
(T)
Victoria Kenyon
(V)
Zachary Kramer
(Z)
Informations de copyright
© 2024 The Author(s). Journal of Pediatric Gastroenterology and Nutrition published by Wiley Periodicals LLC on behalf of European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.
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