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G206(P) The Impact of ESPGHAN Guidelines on the Investigations For Coeliac Disease
  1. M Bhardwaj1,
  2. H Banoub1,
  3. N Sumar2,
  4. M Lawson1,
  5. S Chong1
  1. 1Paediatric Gastroenterology, Queen Marys Hospital for Children, Carshalton, UK
  2. 2Immunology, St Heliers Hospital, Carshalton, UK


Background Coeliac Disease (CD) is an immune-mediated systemic disorder elicited by gluten and related prolamines in genetically susceptible individuals.1 The diagnosis of CD depends on gluten dependant symptoms; CD-specific antibodies – against TG2, endomysial antibodies (EMA), and deamidated forms of gliadin peptides (DGP); the presence of HLA-DQ2/HLA-DQ8 and characteristic histological changes in duodenal biopsy. ESPGHAN guidelines suggest histological assessment may be omitted where clinical symptoms may be attributed to CD in addition to a high IgA anti-tTG levels (>10 times the upper limits of normal for the reference laboratory), verified by EMA positivity and HLA DQ2/DQ8 positivity.1

Aim Review the possible impact of ESPGHAN guidelines on the number of patients requiring histological assessment for CD.

Methods 3 year retrospective review of serology and histology of children screened for CD.

Results January 2009 – January 2012, 729 children screened. 32 positve with normal IgA levels.

Conclusion All but 1 patient with high anti-tTG levels (>10 X) had characteristic histological changes. Anti-tTG levels <10 X normal range in all samples from January 2010 – 2012 and 68% of all positive samples. Our results suggest that in most cases histological assessment will continue to play an important role in the diagnosis of CD. A multicentre prospective study on CD is currently underway.

Abstract G206(P) Table 1
Abstract ASSA13-14-9 Table 1


  1. Husby et al. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition Guidelines for the Diagnosis of Coeliac Disease. J Pediatr Gastroenterol Nutr 2012; 54 (1):136–160

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