Tampere Center for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland.
Department of Pediatrics, Hospital District of South Ostrobothnia, Seinäjoki, Finland.
Acta Paediatr. 2018 Nov;107(11):1879-1887. doi: 10.1111/apa.14468. Epub 2018 Jul 10.
Coeliac disease is a common but markedly under-diagnosed condition, which may lead to serious long-term complications if untreated. Both the diagnostic yield and true incidence have significantly increased during the last few decades and it is now one of the most common chronic gastrointestinal conditions in children. The aim of this review was to summarise the current concepts on screening for coeliac disease in children and adolescents.
We conducted a non-systematic literature review of papers published about coeliac disease screening since the year 2000.
Our review showed that the diagnostic yield could be significantly improved by screening for at-risk groups, or even the whole population, but these approaches remain controversial. Evidence suggests that screening for certain high-risk groups could be beneficial, but untargeted mass screening is not currently recommended. However, whether the benefits of an early diagnosis would overcome the challenges of lifelong dietary treatment, especially in asymptomatic individuals who consider themselves healthy, are unclear.
There is moderate evidence that screening certain at-risk groups for coeliac disease could be beneficial, but more studies in different settings are needed before large-scale population screening can be recommended.
乳糜泻是一种常见但明显诊断不足的疾病，如果不治疗，可能会导致严重的长期并发症。在过去几十年中，其诊断率和实际发病率都显著增加，现在已成为儿童最常见的慢性胃肠道疾病之一。本综述旨在总结目前儿童和青少年乳糜泻筛查的相关概念。
我们对 2000 年以来发表的关于乳糜泻筛查的文献进行了非系统性文献回顾。
我们的综述表明，通过对高危人群甚至整个人群进行筛查，可以显著提高诊断率，但这些方法仍存在争议。有证据表明，对某些高危人群进行筛查可能是有益的，但目前不推荐针对非目标人群进行大规模筛查。然而，早期诊断的益处是否会克服终生饮食治疗的挑战，特别是在无症状但自认为健康的个体中，尚不清楚。
有中等质量证据表明，对某些乳糜泻高危人群进行筛查可能是有益的，但需要在不同环境中进行更多的研究，然后才能推荐对大规模人群进行筛查。
