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- Title
Screening rules for growth to detect celiac disease: a case-control simulation study.
- Authors
van Dommelen P; Grote FK; Oostdijk W; Keizer-Schrama SM; Boersma B; Damen GM; Csizmadia CG; Verkerk PH; Wit JM; van Buuren S; van Dommelen, Paula; Grote, Floor K; Oostdijk, Wilma; Keizer-Schrama, Sabine M P F de Muinck; Boersma, Bart; Damen, Gerard M; Csizmadia, Cassandra G; Verkerk, Paul H; Wit, Jan M; van Buuren, Stef
- Abstract
<bold>Background: </bold>It 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.<bold>Methods: </bold>A 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.<bold>Results: </bold>Body 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.<bold>Conclusion: </bold>For 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.
- Publication
BMC Pediatrics, 2008, Vol 8, p35
- ISSN
1471-2431
- Publication type
journal article
- DOI
10.1186/1471-2431-8-35