Screening rules for growth to detect celiac disease: A case-control simulation studyReport as inadecuate

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BMC Pediatrics

, 8:35

First Online: 11 September 2008Received: 11 October 2007Accepted: 11 September 2008


BackgroundIt is generally assumed that most patients with celiac disease CD have a slowed growth in terms of length or height and weight. However, the effectiveness of slowed growth as a tool for identifying children with CD is unknown. Our aim is to study the diagnostic efficiency of several growth criteria used to detect CD children.

MethodsA case-control simulation study was carried out. Longitudinal length and weight measurements from birth to 2.5 years of age were used from three groups of CD patients n = 134 one group diagnosed by screening, two groups with clinical manifestations, and a reference group obtained from the Social Medical Survey of Children Attending Child Health Clinics SMOCC cohort n = 2,151 in The Netherlands. The main outcome measures were sensitivity, specificity and positive predictive value PPV for each criterion.

ResultsBody mass index BMI performed best for the groups with clinical manifestations. Thirty percent of the CD children with clinical manifestations and two percent of the reference children had a BMI Standard Deviation Score SDS less than -1.5 and a decrease in BMI SDS of at least -2.5 PPV = 0.85%. The growth criteria did not discriminate between the screened CD group and the reference group.

ConclusionFor the CD children with clinical manifestations, the most sensitive growth parameter is a decrease in BMI SDS. BMI is a better predictor than weight, and much better than length or height. Toddlers with CD detected by screening grow normally at this stage of the disease.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2431-8-35 contains supplementary material, which is available to authorized users.

Paula van Dommelen, Floor K Grote contributed equally to this work.

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Author: Paula van Dommelen - Floor K Grote - Wilma Oostdijk - Sabine MPF de Muinck Keizer-Schrama - Bart Boersma - Gerard M Dam


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