Scand J Gastroenterol. 2022 Mar 31;1-9. doi: 10.1080/00365521.2022.2050292.Online ahead of print.

Sunna Gunnarsdottir ¹, Henrik Albrektsson ², Julia Frydebo ³, Nicolae Miron ⁴, Jenny M Kindblom ^5 6, Ketil Størdal ⁷, Karl Mårild ^8 9

Author information

¹Department of Pediatrics, Queen Silvia Children's Hospital, Gothenburg, Sweden.

²Statistiska konsultgruppen, Gothenburg, Sweden.

³Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.

⁴Department of Clinical Immunology, Sahlgrenska University Hospital, Gothenburg, Sweden.

⁵Department of internal medicine and clinical nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.

⁶Pediatric Clinical Research Center, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden.

⁷Department of Pediatric Research, University of Oslo and Oslo University Hospital, Oslo, Norway.

⁸Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden.

⁹Department of Pediatric Gastroenterology, Queen Silvia Children's Hospital, Gothenburg, Sweden.

Abstract

Objectives: Celiac disease (CD) is a common yet largely underdiagnosed disease. This study aimed to test the feasibility of incorporating a non-targeted CD screening in a pediatric outpatient setting and evaluate its short-term impact on children with serological evidence of disease.

Methods: Over five months, 500 children (aged 2-17 years) attending a general pediatric outpatient clinic in Gothenburg, Sweden, were enrolled and surveyed for current symptoms, quality of life, and background characteristics; 481 children were screened for tissue-transglutaminase antibodies (tTGA); repeated tTGA-positivity was defined as CD autoimmunity (CDA). Children with CDA were investigated for CD and for one year monitored for changes in symptoms, and quality of life.

Results: Eleven of 481 (2.3%) screened children had CDA. Children with CDA were younger (median 3.8 years) than those without CDA (8.8 years). No other major between-group differences were reported in background characteristics, symptoms, or quality of life. The screening was well-accepted by the families/participants. During 1-year follow-up, 8 of 11 children with CDA were diagnosed with CD. Children with screening-detected CD reported no significant changes in symptoms and quality of life and the dietary adherence rate was good.

Conclusions: Non-targeted screening for CD was feasible in a general pediatric outpatient setting. While hampered by small sample size, our results are in line with previous screening studies indicating that symptoms do not differentiate CDA from non-CDA children. Also, among an overall minimal-symptomatic group of children, diagnosing CD and installation of treatment did not significantly change their well-being during 1-year follow-up.