Francesco Valitutti

UOC Gastroenterologia ed Epatologia Pediatrica

Policlinico Umberto I

Dipartimento di Pediatria e Neuropsichiatria Infantile,

Sapienza Università di Roma

Direttore: Prof. Salvatore Cucchiara

REVISIONE CRITICA DEI CRITERI DIAGNOSTICI

ESPGHAN 2012 PER LA DIAGNOSI DI CELIACHIA

Roma, 01.03.14

Diagnosis CD

Biopsy -Centred

Metodologia

Creazione dell’ESPGHAN working group dedicato

(2007)

Revisione della letteratura sulla diagnosi di celiachia

negli ultimi decenni

Grades of evidence/ strenght of reccomendation

Voting system

Definition of CD: 2012

CD is a immune-mediaded systemic disorder

elicited by gluten and related prolamines in

genetically susceptible individuals, charactericed

by the presence of variable combination of gluten

dependent clinical manifestation, CD specific

antibodies, HLA DQ2 and DQ8 haplotypes and

enteropathy.

JPGN 2012; 54:136-60.

Take home messages

Possibile omissione della biopsia in casi selezionati

pediatrici (sintomi suggestivi, anti-tTg>10ULN, EMA

pos, HLADQ2 e/o DQ8)

Applicazione esclusivamente nei centri di

gastroenterologia pediatrica di riferimento

Validazione in progress

Non-biopsy diagnosis of CD can be likened to

the young child who asks his parents shortly

after starting a long journey ‘‘are we nearly

there yet?’’ The answer is ‘‘there is still a long

way to go but we are headed in the right

direction.’’

Ivor D. Hill and Karoly Horvath