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Prospective coeliac disease diagnosis evaluation

Principal investigator: Dr Adrian Thomas, Consultant Paediatric Gastroenterologist

Institution: Department of Paediatric Gastroenterology, Hepatology and Nutrition, Royal Manchester Children’s Hospital, Manchester

Research classification: Detection, screening and diagnosis

Project start & duration: 1 November 2012 (30 months)

Grant awarded: £20k

This study will monitor the performance of the new criteria for diagnosing coeliac disease in children, where in some cases the use of a biopsy may not be required.

This is a multicentre study with 3 UK sites and 30 other sites in the EU, Croatia, Iran, Israel, Norway and Russia, involving approximately 600 children with suspected coeliac disease.

The guidance for the diagnosis of coeliac disease in children, published by the British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN) in collaboration with Coeliac UK, proposes that in selected cases, ie children with typical symptoms of coeliac disease and high levels of IgA tissue transglutaminase antibodies, the diagnosis can be confirmed with blood tests alone and without requiring a confirmatory biopsy. The guidance is based on the results of a systematic review of past evidence, whereas this study will look prospectively and will provide additional verification for the recommendations.

The diagnosis of coeliac disease has traditionally required confirmation by an endoscopy (camera inspection of the upper intestine) and small intestinal biopsy (obtaining a sample of the gut lining) which in children is usually done under general anaesthetic (with drug induced sleep in hospital). Sometimes the biopsy is not conclusive and it has to be repeated.

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