FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W2553578429> ?p ?o ?g. }

• W2553578429 endingPage "174" @default.
• W2553578429 startingPage "173" @default.
• W2553578429 abstract "See “Value of IgA tTG in Predicting Mucosal Recovery in Children With Celiac Disease on a Gluten-Free Diet” by Leonard et al on page 286. The role of an intestinal biopsy in the diagnosis and management of celiac disease (CD) in children continues to evolve. Originally 3 biopsies were required to confirm the diagnosis; the first on presentation to demonstrate characteristic changes, the second after a year on the gluten-free diet (GFD) to demonstrate mucosal healing and a third after a gluten challenge to show recurrence of damage (1). With the introduction of reliable serological testing for CD, recommendations changed to require only a single biopsy on presentation that demonstrated the typical histology. Provided there was complete symptom resolution on a GFD the diagnosis of CD was considered confirmed, and normalization of the antibody tests added further support for the diagnosis (2). Most recently the European Society for Pediatric Gastroenterology, Hepatology and Nutrition published recommendations suggesting that in some cases a biopsy may not be necessary. Children with typical symptoms of CD, who have a tissue transglutaminase antibody level >10 times the upper limit of normal together with a positive endomysium antibody and are HLA-DQ2 and or HLA-DQ8 heterodimer positive, can be presumed to have CD and started on a GFD without a biopsy. The diagnosis is then considered confirmed if there is subsequent complete symptom resolution with normalization of antibody levels (3). The presumption is that absence of symptoms and normalization of CD associated antibody tests equals mucosal healing in children. This differs from the experience of our adult gastroenterology colleagues. Over 50% of adults with CD have persistent villous atrophy (VA) on repeat biopsies despite being on a GFD for 2 or more years (4). Furthermore, there is no correlation between the histological findings and the presence or absence of symptoms, or elevations in CD antibody levels (4,5). The importance of this observation is that long-term adverse health consequences associated with CD appears related to persistence of VA (5,6). This raises several questions. Are children really different from adults and if so why? Are absence of symptoms and normal CD antibody levels reliable indicators of mucosal healing in children? Are we as pediatricians missing persistent VA in children and potentially exposing them to long-term complications? The article by Leonard et al (7) in this issue of the Journal of Pediatric Gastroenterology and Nutrition is both timely and thought provoking. In reviewing 103 children with biopsy-proven CD who had undergone a repeat biopsy at least 1 year after starting a GFD, they found that 19% (1 in 5 children) had persistent VA. Furthermore, neither the presence nor absence of symptoms could reliably predict mucosal healing, or the lack thereof, nor were CD serological tests of benefit for this purpose. Although there is one report suggesting a combination of serological tests can be used to predict mucosal recovery (8), others have found the serological tests are less reliable for monitoring response to treatment as compared to initial diagnosis (9). Persistence of VA in children on a GFD has been described by others but not as frequently as that reported by Leonard et al (9,10). However, given that relatively few children with CD now undergo repeat biopsies after starting a GFD, it is possible that the number with persistent VA is much higher than we currently believe. Perhaps it is time for us to rethink our approach to children with CD. Is a non-biopsy diagnosis of CD a good idea or should all children have a diagnostic biopsy, not only to confirm the diagnosis, but establish a baseline for future evaluation? Should all children undergo repeat biopsies after starting a GFD and if so after what period of time? What is the true prevalence of persistent VA in children and what are the likely causative factors? What are the long-term implications of failure to achieve complete mucosal healing? Until we have a reliable non-invasive means of determining mucosal healing in children with CD it seems the biopsy will remain important both for initial diagnosis and subsequent monitoring." @default.
• W2553578429 created "2016-11-30" @default.
• W2553578429 creator A5001740711 @default.
• W2553578429 date "2017-02-01" @default.
• W2553578429 modified "2023-09-23" @default.
• W2553578429 title "Role of Biopsies in Childhood Celiac Disease: Do We Need Less or More?" @default.
• W2553578429 cites W1976374163 @default.
• W2553578429 cites W1986911066 @default.
• W2553578429 cites W1994246726 @default.
• W2553578429 cites W2031954292 @default.
• W2553578429 cites W2059953208 @default.
• W2553578429 cites W2100548379 @default.
• W2553578429 cites W2127587155 @default.
• W2553578429 cites W2548607618 @default.
• W2553578429 cites W4245464873 @default.
• W2553578429 doi "https://doi.org/10.1097/mpg.0000000000001472" @default.
• W2553578429 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/27846068" @default.
• W2553578429 hasPublicationYear "2017" @default.
• W2553578429 type Work @default.
• W2553578429 sameAs 2553578429 @default.
• W2553578429 citedByCount "4" @default.
• W2553578429 countsByYear W25535784292017 @default.
• W2553578429 countsByYear W25535784292019 @default.
• W2553578429 countsByYear W25535784292020 @default.
• W2553578429 crossrefType "journal-article" @default.
• W2553578429 hasAuthorship W2553578429A5001740711 @default.
• W2553578429 hasConcept C126322002 @default.
• W2553578429 hasConcept C142724271 @default.
• W2553578429 hasConcept C159654299 @default.
• W2553578429 hasConcept C178498320 @default.
• W2553578429 hasConcept C181199279 @default.
• W2553578429 hasConcept C185592680 @default.
• W2553578429 hasConcept C203014093 @default.
• W2553578429 hasConcept C2775934546 @default.
• W2553578429 hasConcept C2779134260 @default.
• W2553578429 hasConcept C2780349322 @default.
• W2553578429 hasConcept C3019118998 @default.
• W2553578429 hasConcept C41260117 @default.
• W2553578429 hasConcept C45189115 @default.
• W2553578429 hasConcept C55493867 @default.
• W2553578429 hasConcept C71924100 @default.
• W2553578429 hasConcept C90924648 @default.
• W2553578429 hasConceptScore W2553578429C126322002 @default.
• W2553578429 hasConceptScore W2553578429C142724271 @default.
• W2553578429 hasConceptScore W2553578429C159654299 @default.
• W2553578429 hasConceptScore W2553578429C178498320 @default.
• W2553578429 hasConceptScore W2553578429C181199279 @default.
• W2553578429 hasConceptScore W2553578429C185592680 @default.
• W2553578429 hasConceptScore W2553578429C203014093 @default.
• W2553578429 hasConceptScore W2553578429C2775934546 @default.
• W2553578429 hasConceptScore W2553578429C2779134260 @default.
• W2553578429 hasConceptScore W2553578429C2780349322 @default.
• W2553578429 hasConceptScore W2553578429C3019118998 @default.
• W2553578429 hasConceptScore W2553578429C41260117 @default.
• W2553578429 hasConceptScore W2553578429C45189115 @default.
• W2553578429 hasConceptScore W2553578429C55493867 @default.
• W2553578429 hasConceptScore W2553578429C71924100 @default.
• W2553578429 hasConceptScore W2553578429C90924648 @default.
• W2553578429 hasIssue "2" @default.
• W2553578429 hasLocation W25535784291 @default.
• W2553578429 hasLocation W25535784292 @default.
• W2553578429 hasOpenAccess W2553578429 @default.
• W2553578429 hasPrimaryLocation W25535784291 @default.
• W2553578429 hasRelatedWork W1983493088 @default.
• W2553578429 hasRelatedWork W1987080668 @default.
• W2553578429 hasRelatedWork W2057231004 @default.
• W2553578429 hasRelatedWork W2076896931 @default.
• W2553578429 hasRelatedWork W2078586219 @default.
• W2553578429 hasRelatedWork W2319740193 @default.
• W2553578429 hasRelatedWork W2334425128 @default.
• W2553578429 hasRelatedWork W2410725112 @default.
• W2553578429 hasRelatedWork W2744969343 @default.
• W2553578429 hasRelatedWork W4220798427 @default.
• W2553578429 hasVolume "64" @default.
• W2553578429 isParatext "false" @default.
• W2553578429 isRetracted "false" @default.
• W2553578429 magId "2553578429" @default.
• W2553578429 workType "article" @default.