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G183(P) Awareness of espghan guidelines on coeliac disease among general paediatricians in southwest england
  1. SP Paul1,
  2. HL Adams2,
  3. D Basude3
  1. 1Paediatrics, Torbay Hospital, Torquay, UK
  2. 2University of Bristol, Bristol, UK
  3. 3Paediatric Gastroenterology, Bristol Royal Hospital for Children, Bristol, UK

Abstract

Background ESPGHAN 2012 guidelines on coeliac disease (CD) recommend that symptomatic children with anti-tissue-transglutaminase (anti-tTG) >10 x upper-limit-of-normal (ULN), positive EMA and HLA-DQ2/8, can be diagnosed without biopsy. Serological diagnosis is not appropriate for certain groups of patients.

Aims Gain understanding of awareness and use of ESPGHAN guidelines for diagnosing paediatric CD among general paediatricians

Methods Telephone/email survey was conducted among general paediatric consultants (n»140) across Southwest England. Survey included 8-questions incorporating 3 main themes: when nonbiopsy diagnoses can be made, HLADQ2/8 genotyping should be requested and whether asymptomatic children from high-risk groups with anti-tTG >10xULN can be diagnosed serologically.

Results 85/140 (61%) responses obtained. 83% of paediatricians were unable to state all conditions required for non-biopsy diagnosis. None could describe all situations where HLA-DQ2/8 genotyping should be requested. 33% of paediatricians responded that asymptomatic children with anti-tTG >10xULN can be diagnosed with CD without a biopsy while 24% said they were unsure or would seek advice.

Summary and Conclusions Survey highlighted need for greater in-depth awareness of non-biopsy pathway and situations where HLA-DQ2/8 genotyping is indicated. There is possible misinterpretation regarding the ESPGHAN guidelines as 1/3rd of paediatricians considered non-biopsy pathway is applicable for asymptomatic children. Adequate knowledge of the ESPGHAN guidelines for CD is required among paediatricians. A userfriendly Apps is planned to improve the diagnostic process.

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