{"id":35,"date":"2009-02-24T10:59:00","date_gmt":"2009-02-24T10:59:00","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/gascd\/"},"modified":"2025-05-14T21:03:02","modified_gmt":"2025-05-14T21:03:02","slug":"gascd","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/gascd\/","title":{"rendered":"ESPGHAN Revised Criteria for the Diagnosis of Celiac Disease (CD)"},"content":{"rendered":"<div class=\"99c380e4b4a7b96c35d7ddf7dcb434e8\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p>Celiac disease (CD) is a syndrome characterized by damage of the small intestinal mucosa caused by the gliadin fraction of wheat gluten and similar alcohol-soluble proteins (prolamines) of barley and rye in genetically susceptible subjects. <!--more--><\/p>\n<p class=\"MsoNormal\"><strong>Definite diagnosis of Celiac Disease (CD)<\/strong><\/p>\n<p class=\"MsoNormal\">History and clinical presentation compatible with CD<\/p>\n<ol>\n<li>Serological screening compatible with CD: <strong> <span style=\"font-weight: normal;\"> antigliadin antibody (AGA) antiendomysium antibody (AEA), tissue transglutaminase (tTG) antibody.<\/span><\/strong><\/li>\n<li>Histological findings compatible with CD: villous atrophy<\/li>\n<li>Obvious clinical and serological response to a gluten free diet (GFD)<\/li>\n<li>Subject &gt;2 years old<\/li>\n<li>Rule out other clinical conditions mimicking CD<\/li>\n<\/ol>\n<p class=\"MsoNormal\"><strong> Possible Clinical Manifestations of CD<\/strong><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">A- Typical symptoms<\/p>\n<ul>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Chronic diarrhea<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Failure to thrive<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Abdominal distention<\/p>\n<\/li>\n<\/ul>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">B- Atypical symptoms<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 18px; margin-top: 0pt; margin-bottom: 0pt;\">I- Secondary to malabsorption<\/p>\n<ul>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Sideropenic anemia<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Short stature<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Osteopenia<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Recurrent abortions<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Hepatic steatosis<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Recurrent abdominal pain<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Gaseousness<\/p>\n<\/li>\n<\/ul>\n<p class=\"MsoNormal\" style=\"margin-left: 18px; margin-top: 0pt; margin-bottom: 0pt;\">II- Independent of malabsorption<\/p>\n<ul>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Dermatitis herpetiformis<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Dental enamel hypoplasia<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Ataxia<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Alopecia<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Primary biliary cirrhosis<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Isolated hypertransaminasemia<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Recurrent aphthous stomatitis<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Myasthenia gravis<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Recurrent pericarditis<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Psoriasis<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Polyneuropathy<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Epilepsy (with or without intracranial calcifications)<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Vasculitis<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Dilatative cardiomyopathy<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Hypo\/hyperthyroidism<\/p>\n<\/li>\n<\/ul>\n<p class=\"MsoNormal\"><em> <span style=\"font-style: normal; font-weight: bold;\"> Serologic Screening Tests for the Diagnosis of CD<\/span><\/em><\/p>\n<table style=\"border-collapse: collapse; width: 100%;\" border=\"1\">\n<tbody>\n<tr>\n<td width=\"116\"><b>Test<\/b><\/td>\n<td style=\"text-align: center;\" width=\"116\"><em><span style=\"font-style: normal; font-weight: bold;\">Sensitivity<\/span><\/em><\/td>\n<td style=\"text-align: center;\" width=\"116\"><strong>Specificity<\/strong><\/td>\n<td style=\"text-align: center;\" width=\"116\"><b>PPV<\/b><\/td>\n<td style=\"text-align: center;\" width=\"116\"><b>NPV<\/b><\/td>\n<\/tr>\n<tr>\n<td width=\"116\">AGA IgG<\/td>\n<td style=\"text-align: center;\" width=\"116\">57\u2013100<\/td>\n<td style=\"text-align: center;\" width=\"116\">42\u201398<\/td>\n<td style=\"text-align: center;\" width=\"116\">20\u201395<\/td>\n<td style=\"text-align: center;\" width=\"116\">41\u201388<\/td>\n<\/tr>\n<tr>\n<td width=\"116\">AGA IgA<\/td>\n<td style=\"text-align: center;\" width=\"116\">53\u2013100<\/td>\n<td style=\"text-align: center;\" width=\"116\">65\u2013100<\/td>\n<td style=\"text-align: center;\" width=\"116\">28\u2013100<\/td>\n<td style=\"text-align: center;\" width=\"116\">65\u2013100<\/td>\n<\/tr>\n<tr>\n<td width=\"116\">AEA IgA\u00a0<sup>a<\/sup><\/td>\n<td style=\"text-align: center;\" width=\"116\">75\u201398<\/td>\n<td style=\"text-align: center;\" width=\"116\">96\u2013100<\/td>\n<td style=\"text-align: center;\" width=\"116\">98\u2013100<\/td>\n<td style=\"text-align: center;\" width=\"116\">80\u201395<\/td>\n<\/tr>\n<tr>\n<td width=\"116\">tTG IgA<\/td>\n<td style=\"text-align: center;\" width=\"116\">90-98<\/td>\n<td style=\"text-align: center;\" width=\"116\">95-97<\/td>\n<td width=\"116\"><\/td>\n<td width=\"116\"><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p class=\"MsoNormal\"><em><span style=\"font-style: normal;\"><sup>a<\/sup> Patients older than 2 years.<\/span><\/em><\/p>\n<p class=\"MsoNormal\"><strong> <span style=\"font-weight: normal;\"> Abbreviations: AEA, antiendomysium antibody; AGA, antigliadin antibody; CD, celiac disease; ESPGHAN, European Society of Pediatric Gastroenterology, Hepatology, and Nutrition; GFD, gluten-free diet; Ig, immunoglobulin; tTG, tissue transglutaminase; <\/span> <\/strong><em> <span style=\"font-style: normal;\"> PPV, positive predictive value; NPV, negative predictive value.<\/span><\/em><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p class=\"MsoNormal\"><strong>References:<\/strong><\/p>\n<ol>\n<li class=\"MsoNormal\">Fasano A, Catassi C. Current approaches to diagnosis and treatment of celiac disease: an evolving spectrum. Gastroenterology. 2001 Feb;120(3):636-51. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/11179241\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Fasano A, Catassi C. Celiac disease.\u00a0 N Engl J Med. 2012 Dec 13;367(25): 2419-26. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/23252527\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Created: May 17, 2008<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Sorry, this entry is only available in Espa\u00f1ol.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"","_lmt_disable":"","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[53],"tags":[1892,1891,1890,16,15,123,51,50,1889,1413,820,8,7],"class_list":["post-35","post","type-post","status-publish","format-standard","hentry","category-gastroenterology","tag-cd","tag-celiac","tag-celiacasdiagnostico","tag-criteria","tag-criterios","tag-diagnosis","tag-disease","tag-enfermedad","tag-espghan","tag-gastroenterology","tag-proposed","tag-revisados","tag-revised"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/35","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/comments?post=35"}],"version-history":[{"count":5,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/35\/revisions"}],"predecessor-version":[{"id":8899,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/35\/revisions\/8899"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/media?parent=35"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/categories?post=35"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/tags?post=35"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}