Impact of ESPGHAN no-biopsy strategy on the outcome of celiac disease treatment in children

Iulia Enache ^1,2 Mariana Jinga ^1,2* Alexandra Palaga ³ Daniel Vasile Balaban ^1,2 Felicia Galos ^1,4 Dhea-Maria Macovei ³ Alina Popp ^1,3

• ¹ Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
• ² Dr. Carol Davila Central Military Emergency University Hospital, Buchatest, Romania
• ³ Alessandrescu-Rusescu National Institute for Mother and Child Health, Bucharest, Romania
• ⁴ Marie-Curie Emergency Children’s Hospital, Department of Pediatrics, Bucharest, Romania, Bucharest, Romania

We here present 63 celiac disease pediatric patients diagnosed in our clinic between 2010-2014 and followed for as long as 10 years. The time period is important, because it overlapped with major changes in ESPGHAN 2012 guidelines which allowed the diagnosis of celiac disease without the requirement of intestinal biopsies in children presenting with antitransglutaminase IgA titers above ten times upper limit of normal. All of our patients met this condition, but according to the time frame, their celiac disease diagnosis was established either with intestinal biopsies or solely by serology. We then compared the 2 groups at diagnosis and at regular follow-ups (1 year, 2 years and 8-10 years) regarding their clinical and laboratory findings, as well as compliance to the gluten-free diet and their attendance to regular followups. Our data suggest that the no-biopsy group calls for special attention, as they take longer to heal, they are more prone to gluten-free diet transgressions and h