Experts recommend best practices for kids with celiac disease

By Van Waffle

Until now, doctors have no had clear guidelines on follow-up care for kids with celiac disease. A panel of North American experts has attempted to address this by recommending best practices to manage children with the disease.

Guidelines were based on an extensive review of existing research. The panel of seven experts considered the data supporting each guideline, graded the evidence, took their individual experiences treating patients into account and voted anonymously whether to recommend the guideline as a best practice. The panel reached consensus on 24 of 25 questions, voting unanimously on 15.

The guidelines cover six areas of concern, including bone health, blood problems, endocrine disorders, liver health, nutritional concerns and diagnostic testing for celiac disease. They indicate which tests and counseling doctors should undertake when a patient is newly diagnosed with celiac disease and in subsequent follow-up.

Some of the guidelines that received unanimous support included testing for immunoglobin A anti-tissue transglutaminase (tTG) as part of initial diagnosis, screening diagnosed patients for anemia and thyroid disease, providing access to an experienced dietitian, recommending multivitamin supplements and repeat tTG testing to monitor compliance with a gluten-free diet.

 

Snyder J, Butzner JD, DeFelice AR, Fasano A, Guandalini S, Liu E and Newton KP, “Evidence-informed expert recommendations for the management of celiac disease in children,” Pediatrics, Sept 2016, doi:10.1542/peds.2015-3147.