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Usefulness of symptoms to screen for celiac disease
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
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2014 (English)In: Pediatrics, ISSN 0031-4005, Vol. 133, no 2, 211-218 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To describe the frequency of symptoms and associated conditions among screening-detected celiac disease (CD) cases and non-CD children and to evaluate questionnaire-based case-finding targeting the general population.

METHODS: In a population-based CD screening of 12-year-olds, children and their parents completed questionnaires on CD-associated symptoms and conditions before knowledge of CD status. Questionnaire data for those who had their CD detected in the screening (n = 153) were compared with those of children with normal levels of CD markers (n = 7016). Hypothetical case-finding strategies were also evaluated. Questionnaires were returned by 7054 (98%) of the children and by 6294 (88%) of their parents.

RESULTS: Symptoms were as common among screening-detected CD cases as among non-CD children. The frequency of children with screening-detected CD was similar when comparing the groups with and without any CD-related symptoms (2.1% vs 2.1%; P = .930) or CD-associated conditions (3.6% vs 2.1%; P = .07). Case-finding by asking for CD-associated symptoms and/or conditions would have identified 52 cases (38% of all cases) at a cost of analyzing blood samples for 2282 children (37%) in the study population.

CONCLUSIONS: The current recommended guidelines for finding undiagnosed CD cases, so-called active case-finding, fail to identify the majority of previously undiagnosed cases if applied in the general population of Swedish 12-year-olds. Our results warrant further studies on the effectiveness of CD case-finding in the pediatric population, both at the clinical and population-based levels.

Place, publisher, year, edition, pages
2014. Vol. 133, no 2, 211-218 p.
Keyword [en]
case-finding, celiac disease, questionnaire, screening, symptom
National Category
Medical and Health Sciences
URN: urn:nbn:se:umu:diva-88852DOI: 10.1542/peds.2012-3765ISI: 000333413600006PubMedID: 24420802OAI: diva2:717714
Available from: 2014-05-16 Created: 2014-05-16 Last updated: 2015-04-29Bibliographically approved

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Rosén, AnnaSandström, OlofStenlund, HansIvarsson, Anneli
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