Celiac disease in the Mediterranean area

BMC Gastroenterology

Research Article

Eleftheria Roma¹  Zrinjka Misak²  Sanja Kolaček²  Mona Abu-Zekry³  Veselinka Djurisic⁴  Ghazalia Boudraa⁵  Selma Terzic⁶  José Ramon Bilbao⁷  Renata Auricchio⁸  Luca Astarita⁸  Carmela Arcidiaco⁸  Francesca Tucci⁸  Luigi Greco⁹  Aydan Kansu^1,10  Virtut Velmishi^1,11  Abdelhak Abkari^1,12  Samir Boukthir^1,13  Pasqualino Rossi^1,14  Thomas Attard^1,15  Mongi Ben Hariz^1,16  Iñaki Irastorza^1,17  Stefano Costa^1,18  Giuseppe Magazzù^1,18  Jean-Pierre Hugot^1,19  Dušanka Mičetić-Turk^2,20 

[1] Aghia Sophia Children’s Hospital, Athens University, 11527, Goudi, Athens, Greece;Children’s Hospital Zagreb, 10000, Zagreb, Croatia;Children’s Hospital, Gastrointestinal Unit, Cairo University, 12511, Cairo, Egypt;Clinical Centre of Montenegro, Institute for Children s Disease, Podgorica, Montenegro;Clinique Amilcar Cabral, 31026, Oran, Algeria;Department of Children Diseases, University Clinical Center, Tuzla, Bosnia and Herzegovina;Endocrinology, Diabetes and Nutrition Research Group, Hospital de Cruces, 48903, Barakaldo-Bizkaia, Basque Country, Spain;BioCruces Research Institute, Cruces University Hospital, University of the Basque Country (UPV-EHU), Barakaldo, Basque Country, Spain;European Laboratory for Food Induced Diseases, University of Naples Federico II, 80131, Naples, Italy;European Laboratory for Food Induced Diseases, University of Naples Federico II, 80131, Naples, Italy;European Laboratory for Food-Induced Diseases, Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy;Faculty of Medicine, Department of Pediatric Gastroenterology, Ankara University, 06100, Ankara, Turkey;Gastrohepatology of University Hospital Centre “Mother Teresa”, 1000, Tirana, Albania;Hôpital des Enfant IbnRochd de Casablanca, 20050, Casablanca, Morocco;Hôpital d’enfants, Tunis, Tunisia;International Affairs Direction, Ministry of Health, Rome, Italy;Mater Dei Hospital, 2090, Msida, MSD, Malta;Paediatric Unit, Mongi SLIM’s Hospital of Tunis, 2078, Marsa, Tunisia;Pediatric Gastroenterology, Hospital de Cruces, 48903, Barakaldo, Spain;BioCruces Research Institute, Cruces University Hospital, University of the Basque Country (UPV-EHU), Barakaldo, Basque Country, Spain;Regional Celiac Center, University Hospital G. Martino, 98125, Messina, Italy;UMR843, INSERM, Assistance Publique Hopitaux de Paris et Université, Paris Diderot, Paris, France;University Medical Centre Paediatric Department, Ljubljanska, 2000, Maribor, Slovenia;

关键词: Mediterranean area;    Celiac disease;    World gastroenterology organization;    ESPGHAN guidelines;   

DOI  :  10.1186/1471-230X-14-24

 received in 2013-07-18, accepted in 2014-01-30,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundThe World Gastroenterology Organization recommends developing national guidelines for the diagnosis of Celiac Disease (CD): hence a profile of the diagnosis of CD in each country is required. We aim to describe a cross-sectional picture of the clinical features and diagnostic facilities in 16 countries of the Mediterranean basin. Since a new ESPGHAN diagnostic protocol was recently published, our secondary aim is to estimate how many cases in the same area could be identified without a small intestinal biopsy.MethodsBy a stratified cross-sectional retrospective study design, we examined clinical, histological and laboratory data from 749 consecutive unselected CD children diagnosed by national referral centers.ResultsThe vast majority of cases were diagnosed before the age of 10 (median: 5 years), affected by diarrhea, weight loss and food refusal, as expected. Only 59 cases (7.8%) did not suffer of major complaints. Tissue transglutaminase (tTG) assay was available, but one-third of centers reported financial constraints in the regular purchase of the assay kits. 252 cases (33.6%) showed tTG values over 10 times the local normal limit. Endomysial antibodies and HLA typing were routinely available in only half of the centers. CD was mainly diagnosed from small intestinal biopsy, available in all centers. Based on these data, only 154/749 cases (20.5%) would have qualified for a diagnosis of CD without a small intestinal biopsy, according to the new ESPGHAN protocol.ConclusionsThis cross-sectional study of CD in the Mediterranean referral centers offers a puzzling picture of the capacities to deal with the emerging epidemic of CD in the area, giving a substantive support to the World Gastroenterology Organization guidelines.

【 授权许可】

Unknown   
© Tucci et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.