Diagnostic Delays in Children With Coeliac Disease in the Central European Region. Issue 4 (October 2019)

• Record Type: Journal Article
• Authors: Riznik, Petra; De Leo, Luigina; Dolinsek, Jasmina; Gyimesi, Judit; Klemenak, Martina; Koletzko, Berthold; Koletzko, Sibylle; Korponay-Szabó, Ilma Rita; Krencnik, Tomaz; Not, Tarcisio; Palcevski, Goran; Sblattero, Daniele; Vogrincic, Matej; Werkstetter, Katharina Julia; Dolinsek, Jernej
• Is Part Of: Journal of pediatric gastroenterology and nutrition. Volume 69:Issue 4(2019)
• Publication Date: 2019-10
• Subjects: Central Europe -- children -- coeliac disease -- diagnostic delays; Children -- Nutrition -- Periodicals; Pediatric gastroenterology -- Periodicals; Infants -- Nutrition -- Periodicals; Nutrition disorders in children -- Periodicals; Child Nutrition -- Periodicals; Digestive System -- growth & development -- Periodicals; Gastrointestinal Diseases -- Periodicals; Infant Nutrition -- Periodicals; Nutrition Disorders -- Periodicals; Child; 618.923
• DOI: 10.1097/MPG.0000000000002424
• Languages: English
• ISSNs: 0277-2116

Abstract

ABSTRACT: Objectives: Coeliac disease (CD) is a systemic autoimmune disorder affecting about 1% of the population. Many patients remain undiagnosed or are diagnosed with substantial delay. We assessed diagnostic delays in symptomatic CD children in Central Europe (CE). Methods: Paediatric gastroenterologists in 5 CE countries retrospectively reported data of their patients diagnosed in 2016. Age at first CD-related symptom(s), first visit to paediatric gastroenterologist and confirmed diagnosis were used to determine diagnostic delays. Results: Data from 393 children (65% girls, median age 7 years, range 7 months to 18.5 years) from Croatia, Hungary, Germany, Italy, and Slovenia were analysed. Median duration from first symptom(s) to visit to paediatric gastroenterologist was 5 months (range 0–10 years; preschool 4 months, school-aged 5 months), and further duration until final diagnosis was 1 month (range 0–5 years) with significant regional differences ( P < 0.001). Median diagnostic delay was 6 months (range 0–10 years; preschool 5 months, school-aged 7 months). Type of clinical presentation had little, however, significant effect on delays. Reduced body mass in delays longer than 3 years compared with delays shorter than 1 year was found ( z score −0.93 vs −0.39, P < 0.05). Conclusions: Time from first symptoms to CD diagnosis in children in 5 CE countries is slightly shorter compared with few other small paediatric studies, and significantly shorter than reported for adults. Nevertheless, delays of more than 3 years in 6.6% of children are worrisome. Raising awareness about the variable symptoms and implementation of reliable diagnostic tools will further reduce diagnostic delays.