Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Center for Child Health Research, Tampere University and Department of Pediatrics, Tampere University Hospital, Tampere, Finland.
Center for Child Health Research, Tampere University and Department of Pediatrics, Tampere University Hospital, Tampere, Finland; University of Helsinki and Helsinki University Hospital, Children's Hospital, and Pediatric Research Center, Helsinki, Finland.
Dig Liver Dis. 2020 Nov;52(11):1315-1322. doi: 10.1016/j.dld.2020.08.010. Epub 2020 Sep 6.
Early detection of celiac disease could theoretically prevent most of the disease-associated complications, but long-term effects of this approach are unclear.
To investigate features at diagnosis and adulthood health in celiac disease patients diagnosed in early childhood in 1965-2014.
Medical data on 978 pediatric patients were collected and study questionnaires sent to 559 adult patients who were diagnosed in childhood. Results were compared between patients diagnosed in early (≤3.0 years) and later (3.1-17.9 years) childhood.
Early diagnosed patients (n=131) had more often total villous atrophy (37% vs 25%, p=0.001), gastrointestinal presentation (61% vs 47%, p<0.001), growth disturbances (70% vs 32%, p=0.001) and severe symptoms (30% vs 9%, p<0.001) and were less often screen-detected (10% vs 27%, p<0.001) at diagnosis than those diagnosed later (n=847). Among 239 adult responders, early diagnosed patients (n=36) had fewer comorbidities (33% vs 53%, p=0.034) but considered their health less often good/excellent (69% vs 84%, p=0.029). The groups were comparable in current age, dietary adherence, symptoms and health-related quality of life.
Despite more severe initial presentation, the long-term health in early diagnosed patients was mostly comparable or even better to those diagnosed later in childhood. Poorer self-perceived health suggests a need for support during the transition to adulthood care.
理论上，早期发现乳糜泻可以预防大多数与疾病相关的并发症，但这种方法的长期效果尚不清楚。
研究 1965 年至 2014 年间在儿童早期被诊断为乳糜泻的患者在诊断时和成年后的健康特征。
收集了 978 名儿科患者的医疗数据，并向 559 名在儿童期被诊断为乳糜泻的成年患者发送了研究问卷。将在儿童早期（≤3.0 岁）和晚期（3.1-17.9 岁）被诊断为乳糜泻的患者进行比较。
早期诊断患者（n=131）更常出现全部绒毛萎缩（37% vs 25%，p=0.001）、胃肠道表现（61% vs 47%，p<0.001）、生长障碍（70% vs 32%，p=0.001）和严重症状（30% vs 9%，p<0.001），且在诊断时比晚期诊断的患者（n=847）更不易被筛查发现（10% vs 27%，p<0.001）。在 239 名成年应答者中，早期诊断患者（n=36）的合并症较少（33% vs 53%，p=0.034），但他们认为自己的健康状况不太好/很好（69% vs 84%，p=0.029）。两组在当前年龄、饮食依从性、症状和健康相关生活质量方面相当。
尽管早期诊断的患者初始表现更为严重，但他们的长期健康状况在大多数情况下与在儿童晚期被诊断的患者相当，甚至更好。较差的自我感知健康状况表明在向成年期护理过渡期间需要提供支持。
