BACKGROUND: Celiac disease (CD) is a prevalent condition with a broad spectrum of presentations requiring a lifelong gluten-free diet (GFD). Our aims were to examine the presentation and adherence to a GFD as well as the adequacy of follow-up of children diagnosed with CD at a tertiary referral center. METHODS: A retrospective electronic chart review of pediatric patients suspected of CD (n = 581) who were seen at our institute between January 1999 and December 2008 was performed. RESULTS: 387 children were diagnosed with CD (F/M ratio of 1.54, median age: 6.25 years). Presenting symptoms were iron deficiency anemia (n = 82, 34%), short stature (n = 59, 24.5%) and abdominal pain (n = 59, 24.5%). In 63 patients (16.3%) an associated autoimmune disease was recorded. Only 42.7% of the patients (165/387) had regular out-patient gastroenterologist visits; 22% (86/387) were followed by their primary care physician. Over 35% (136/387) were completely lost to follow-up. Negative serology on follow-up was present in 91% of the CD patients(150/165) followed at our center in comparison to 70% (60/86) in those followed up by their primary physician (p = 0.0002). CONCLUSIONS: At least in our referral center, follow-up of children diagnosed with CD is far from satisfactory. Initiatives aimed at improving adherence to regular follow-up are needed as this intervention is associated with a significant increase in patient compliance with a long-term GFD.
BACKGROUND:Celiac disease (CD) is a prevalent condition with a broad spectrum of presentations requiring a lifelong gluten-free diet (GFD). Our aims were to examine the presentation and adherence to a GFD as well as the adequacy of follow-up of children diagnosed with CD at a tertiary referral center. METHODS: A retrospective electronic chart review of pediatric patients suspected of CD (n = 581) who were seen at our institute between January 1999 and December 2008 was performed. RESULTS: 387 children were diagnosed with CD (F/M ratio of 1.54, median age: 6.25 years). Presenting symptoms were iron deficiency anemia (n = 82, 34%), short stature (n = 59, 24.5%) and abdominal pain (n = 59, 24.5%). In 63 patients (16.3%) an associated autoimmune disease was recorded. Only 42.7% of the patients (165/387) had regular out-patient gastroenterologist visits; 22% (86/387) were followed by their primary care physician. Over 35% (136/387) were completely lost to follow-up. Negative serology on follow-up was present in 91% of the CDpatients(150/165) followed at our center in comparison to 70% (60/86) in those followed up by their primary physician (p = 0.0002). CONCLUSIONS: At least in our referral center, follow-up of children diagnosed with CD is far from satisfactory. Initiatives aimed at improving adherence to regular follow-up are needed as this intervention is associated with a significant increase in patient compliance with a long-term GFD.
Authors: Margot L Herman; Alberto Rubio-Tapia; Brian D Lahr; Joseph J Larson; Carol T Van Dyke; Joseph A Murray Journal: Clin Gastroenterol Hepatol Date: 2012-05-18 Impact factor: 11.382
Authors: Emily Haddad; Ahmet Ali Sancaktutar; Blake W Palmer; Christopher Aston; Bradley P Kropp Journal: J Pediatr Urol Date: 2018-03-19 Impact factor: 1.921
Authors: Jonas F Ludvigsson; Lars Agreus; Carolina Ciacci; Sheila E Crowe; Marilyn G Geller; Peter H R Green; Ivor Hill; A Pali Hungin; Sibylle Koletzko; Tunde Koltai; Knut E A Lundin; M Luisa Mearin; Joseph A Murray; Norelle Reilly; Marjorie M Walker; David S Sanders; Raanan Shamir; Riccardo Troncone; Steffen Husby Journal: Gut Date: 2016-04-18 Impact factor: 23.059