Spanish National Registry of Paediatric Coeliac Disease: Changes in the Clinical Presentation in the 21st Century.
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Pérez Solís David, Cilleruelo Pascual Ma Luz, Ochoa Sangrador Carlos, García Burriel Jose Ignacio, Sánchez-Valverde Visus Félix, Eizaguirre Arocena Francisco Javier, Garcia Calatayud Salvador, Martinez-Ojinaga Nodal Eva, Donat Aliaga Ester, Barrio Torres Josefa, Castillejo de Villasante Gemma, Miranda Cid Ma Del Carmen, Torres Peral Ricardo, Vecino Lopez Raquel, Juste Ruiz Mercedes, Armas Ramos Honorio, Barros Garcia Patricia, Leis Trabazo Rosaura, Solaguren Alberdi Rosa, Salazar Quero José Carlos, Garcia Romero Ruth, Ortigosa Del Clastillo Luis, Peña Quintana Luis, Urruzuno Telleria Pedro, Codoñer Franch Pilar, Garcia Casales Zuriñe, Masiques Mas Maria Lluïsa, Galicia Poblet Gonzalo, Martinez Costa Cecilia, Balmaseda Serrano Elena, Polanco Allué Isabel, Ribes Koninck Carmen, Román Riechmann Enriqueta, Coeliac Disease Working Group of the Spanish Gastroenterology, Hepatology, Paediatric Nutrition Society (SEGHNP)
Аннотация
METHODS: A nationwide prospective, observational, multicentre registry of new paediatric CD cases was conducted from January 2011 to June 2017. The data regarding demographic variables, type of birth, breast-feeding history, family history of CD, symptoms, height and weight, associated conditions, serological markers, human leukocyte antigen (HLA) phenotype, and histopathological findings were collected.
RESULTS: In total, 4838 cases (61% girls) from 73 centres were registered. The median age at diagnosis was 4 years. Gastrointestinal symptoms were detected in 71.4% of the patients, and diarrhoea was the most frequent symptom (45.9%). The most common clinical presentation was the classical form (65.1%) whereas 9.8% ofthe patients were asymptomatic. There was a trend towards an increase in the age at diagnosis, proportion of asymptomatic CD cases, and usage of anti-deamidated gliadin peptide antibodies and HLA typing for CD diagnosis. There was, however, a decreasing trend in the proportion of patients undergoing biopsies. Some of these significant trend changes may reflect the effects of the 2012 ESPGHAN diagnosis guidelines.
CONCLUSIONS: Paediatric CD in Spain is evolving in the same direction as in the rest of Europe, although classical CD remains the most common presentation form, and the age at diagnosis remains relatively low.