Table 3 Self-reported practices of primary-care pediatricians on the management of celiac disease (CD) in children
Number/ Total (percent) | Weighted percent* | Comment [6] | |
|---|---|---|---|
Reasons for testing for CD | Patients with CD may present with a wide range of symptoms and signs or be asymptomatic | ||
Chronic/intermittent diarrhea | 100/108 (93%) | 92% | |
Growth impairment | 105/108 (97%) | 98% | |
IDA | 102/108 (94%) | 95% | |
Abdominal pain | 92/108 (85%) | 86% | |
Reasons for screening for CD | First-degree relatives with CD, type 1 diabetes, Down syndrome, Turner syndrome autoimmune thyroid disease, Williams syndrome, IgA deficiency and autoimmune liver disease. | ||
Autoimmune diseases, e.g., type 1 diabetes | 99/108 (92%) | 91% | |
Down syndrome | 66/108 (61%) | 62% | |
First-degree relatives of CD patients | 106/108 (98%) | 98% | |
Referral for diagnosis in suspected cases of CD** | |||
Specialist in gastroenterology | 17/108 (16%) | 16% | |
Serological assays | 108/108 (100%) | 100% | Recommended as the first tool to identify patients with symptoms and signs suggestive of CD for further diagnostic workup |
In cases of positive serological test; referral to specialist in gastroenterology for final diagnosis. | 96/108 (89%) | 90% | If anti-TG2 antibody testing is positive, then patients should be referred to a pediatric gastroenterologist for further diagnostic workup |
Final decision of intestinal biopsy by specialist in gastroenterology | 106/108 (98%) | 98% | |
Treatment and follow-up** | |||
Recommend on gluten free diet only after diagnosis of CD | 107/107 (100%) | 100% | |
Recommend yearly follow-up for physical growth | 106/108 (98%) | 98% | |
Recommend follow-up by specialist in gastroenterology | 69/108 (64%) | 65% | |