tailieunhanh - European Society for Pediatric Gastroenterology, Hepatology, and Nutrition Guidelines for the Diagnosis of Coeliac Disease

According to local inhabitants, garden productivity in the Upper Orinoco region was significantly below normal at the time of the study, a fact that can be attributed to the El Niño weather conditions in 1997–1998. Colleagues in the region conducted several aerial surveys, and provided convincing photographic evidence that many local gardens had been damaged by heavy flooding. During the field season, there were numerous reports of food shortages in the Yanomamö and Ye’kwana communities along the river. Inhabitants of the study site reported that they were no longer suffering shortages, although they had been a few months earlier. During that time, village leaders travelled to local missions. | Clinical Guideline European Society for Pediatric Gastroenterology Hepatology and Nutrition Guidelines for the Diagnosis of Coeliac Disease S. Husby yS. Koletzko IR. Korponay-Szabo . Mearin jjA. Phillips R. Shamir R. Troncone K. Giersiepen D. Branski zzC. Catassi M. Lelgeman jlllM. Maki C. Ribes-Koninckx A. Ventura and . Zimmer for the ESPGHAN Working Group on Coeliac Disease Diagnosis on behalf of the ESPGHAN Gastroenterology Committee ABSTRACT Objective Diagnostic criteria for coeliac disease CD from the European Society for Paediatric Gastroenterology Hepatology and Nutrition ESP-GHAN were published in 1990. Since then the autoantigen in cd tissue transglutaminase has been identified the perception of CD has changed from that of a rather uncommon enteropathy to a common multiorgan disease strongly dependent on the haplotypes human leukocyte antigen HLA -DQ2 and HLA-DQ8 and CD-specific antibody tests have improved. Methods A panel of 17 experts defined CD and developed new diagnostic criteria based on the Delphi process. Two groups of patients were defined with different diagnostic approaches to diagnose CD children with symptoms suggestive of CD group 1 and asymptomatic children at increased risk for CD group 2 . The 2004 National Institutes of Health Agency for Healthcare Research and Quality report and a systematic literature search on antibody tests for CD in paediatric patients covering the years 2004 to 2009 was the basis for the evidence-based recommendations on CD-specific antibody testing. Results In group 1 the diagnosis of CD is based on symptoms positive serology and histology that is consistent with cd. If immunoglobulin A anti-tissue transglutaminase type 2 antibody titers are high 10 times the upper limit of normal then the option is to diagnose CD without duodenal biopsies by applying a strict protocol with further laboratory tests. In group 2 the diagnosis of CD is based on positive serology and histology. HLA-DQ2 and HLA-DQ8 testing is .

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