Adherence to Gluten-free Diet in a Celiac Pediatric Population Referred to the General Pediatrician After Remission.
J Pediatr Gastroenterol Nutr
; 71(1): 78-82, 2020 07.
Article
em En
| MEDLINE
| ID: mdl-32097372
ABSTRACT
OBJECTIVES:
Assessment of adherence to gluten-free diet in celiac disease (CD) is generally recommended. Few data are available about consequences of transition from the referral center to the general pediatrician (GP) once remission is achieved.METHODS:
Adherence was assessed in patients referred to the GP for an annual basis follow-up, called back for re-evaluation. Immunoglobulin A (IgA) antitissue transglutaminase (anti-tTG) antibodies and the Biagi score (BS) were determined at last follow-up at the referral center (V1), and at re-evaluation (V2). Patients were classified as adherent (BS 3-4, IgA anti-tTG <7âU/mL) and nonadherent (BS 0-2, IgA anti-tTG ≥7). Scores of adherence were correlated with personal and clinical data.RESULTS:
We evaluated 200 patients. Overall, we found good adherence rates in 94.95% of patients at V1 and 83.5% at V2. IgA anti-tTG were negative in 100% at V1 and 96.97% at V2. BS is 3 to 4 in 94.5% at V1 and 84% at V2. Adherence at V2 was significantly worse than V1 (Pâ<â0.001). No significant associations were found between scores of adherence and sex, symptoms and age at diagnosis, family history of CD, comorbidity, and diagnosis by endoscopy. Age 13 years or older represents a risk factor for lack of compliance at V1 (Pâ=â0.02) and V2 (Pâ=â0.04), and foreign nationality at V2 (Pâ=â0.001).CONCLUSIONS:
The BS, serology, and a clinical interview, integrated, are reliable tools for assessing pediatric adherence to gluten-free diet. We argue that referring patients to the GP after remission of CD is important, but the process must be improved and recommendations are required.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doença Celíaca
/
Dieta Livre de Glúten
Tipo de estudo:
Guideline
/
Risk_factors_studies
Limite:
Adolescent
/
Child
/
Humans
Idioma:
En
Revista:
J Pediatr Gastroenterol Nutr
Ano de publicação:
2020
Tipo de documento:
Article