TAILIEUCHUNG - Guideline for the Diagnosis and Treatment of Celiac Disease in Children: Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition

There is no direct gold standard evidence or specific UK or European consensus guidelines for monitoring the growth of children with moderate to severe renal disease. This document therefore aims to define minimum standards for measuring and monitoring growth in children with CKD, based on local expert opinion, international committee reports, and indirectly supportive peer-reviewed clinical trials and reviews. Multiple measures are necessary 15,19 to give a broad and reliable picture of growth and nutrition, and the frequency of measurement will depend on the child’s age and stage of CKD (see appendix 1). Children displaying growth delay or unstable medical. | JOBNAME gas 40 1 2005 PAGE 1 OUTPUT Wed December 15 18 39 15 2004 lww gas 84141 MPG157309 Prod MPG157309 MS xxx Journal of Pediatric Gastroenterology and Nutrition 40 1-19 January 2005 Lippincott Williams Wilkins Philadelphia Clinical Guideline Guideline for the Diagnosis and Treatment of Celiac Disease in Children Recommendations of the North American Society for Pediatric Gastroenterology Hepatology and Nutrition ABSTRACT Celiac disease is an immune-mediated enteropathy caused by a permanent sensitivity to gluten in genetically susceptible individuals. It occurs in children and adolescents with gastrointestinal symptoms dermatitis herpetiformis dental enamel defects osteoporosis short stature delayed puberty and persistent iron deficiency anemia and in asymptomatic individuals with type 1 diabetes Down syndrome Turner syndrome Williams syndrome selective immunoglobulin Ig A deficiency and first degree relatives of individuals with celiac disease. The Celiac Disease Guideline Committee of the North American Society for Pediatric Gastroenterology Hepatology and Nutrition has formulated a clinical practice guideline for the diagnosis and treatment of pediatric celiac disease based on an integration of a systematic review of the medical literature combined with expert opinion. The Committee examined the indications for testing the value of serological tests human leukocyte antigen HLA typing and histopathology and the treatment and monitoring of children with celiac disease. It is recommended that children and adolescents with symptoms of celiac disease or an increased risk for celiac disease have a blood test for antibody to tissue transglutaminase TTG that those with an elevated TTG be referred to a pediatric gastroenterologist for an intestinal biopsy and that those with the characteristics of celiac disease on intestinal histopathology be treated with a strict gluten-free diet. This document represents the official recommendations of the North American Society .

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