Department of Paediatrics, University of Otago, 2 Riccarton Avenue, Christchurch, 8011, New Zealand.
Department of Surgery, University of Otago, 2 Riccarton Avenue, Christchurch, 8011, New Zealand.
Dig Dis Sci. 2022 May;67(5):1744-1752. doi: 10.1007/s10620-021-06988-2. Epub 2021 Apr 30.
The application of the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) celiac disease (CeD) guidelines by pediatric gastroenterologists in Australia and New Zealand (Australasia) is unknown. Similarly, long-term management practices for patients with CeD are also unknown in this region.
This study aimed to explore the perceptions and practices of Australasian pediatric gastroenterologists in diagnosing and managing patients with CeD.
Australasian pediatric gastroenterologists and trainees were invited to complete an anonymous online survey over a 3-week period.
The survey was completed by 28 respondents, 24 from Australia and four from New Zealand. Tissue transglutaminase antibody IgA was the most frequently ordered initial serologic test. Fifteen (54%) respondents relied on duodenal biopsies for the confirmation of CeD, six (21%) followed the ESPGHAN guidelines and the remaining seven offered either biopsy confirmation or no-biopsy diagnosis according to the parents' wishes. Following diagnosis, five (18%) respondents discharged patients from care, three (11%) discharged patients after one follow-up visit, one (4%) reviewed patients for 12 months, six (21%) reviewed patients until celiac antibodies normalized and children were clinically asymptomatic, and 13 (46%) reviewed patients until transition to adult care.
Tissue transglutaminase antibody IgA was the most common initial serologic test ordered by this group of Australasian pediatric gastroenterologists. Half of these physicians rely solely on duodenal biopsy for the confirmation of CeD diagnosis: a minority routinely use the ESPGHAN guidelines. Physicians reported a wide range of CeD follow-up practices.
欧洲小儿肠胃病学、肝病学和营养学学会（ESPGHAN）的乳糜泻（CeD）指南在澳大利亚和新西兰（澳大拉西亚）的儿科胃肠病学家中的应用情况尚不清楚。同样，该地区也不清楚 CeD 患者的长期管理实践。
本研究旨在探讨澳大拉西亚儿科胃肠病学家在诊断和管理 CeD 患者方面的看法和做法。
邀请澳大拉西亚儿科胃肠病学家和受训者在 3 周内完成一项匿名在线调查。
共有 28 名受访者完成了调查，其中 24 名来自澳大利亚，4 名来自新西兰。组织转谷氨酰胺酶抗体 IgA 是最常被要求进行的初始血清学检测。15 名（54%）受访者依靠十二指肠活检来确认 CeD，6 名（21%）遵循 ESPGHAN 指南，其余 7 名根据家长的意愿提供活检确认或无活检诊断。确诊后，5 名（18%）受访者将患者从治疗中释放，3 名（11%）在一次随访后将患者释放，1 名（4%）在 12 个月后对患者进行审查，6 名（21%）在患者的乳糜泻抗体正常化且儿童临床无症状时对患者进行审查，13 名（46%）在患者过渡到成人治疗时对患者进行审查。
组织转谷氨酰胺酶抗体 IgA 是该组澳大拉西亚儿科胃肠病学家最常要求的初始血清学检测。其中一半的医生仅依靠十二指肠活检来确认 CeD 诊断：少数医生常规使用 ESPGHAN 指南。医生报告了广泛的 CeD 随访实践。
