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Transition from childhood to adulthood in coeliac disease: the Prague consensus report

Ludvigsson, J.F.; Agreus, L.; Ciacci, C.; Crowe, S.E.; Geller, M.G.; Green, P.H.R.; Hill, I.; Hungin, A.P.S.; Koletzko, S.; Koltai, T.; Lundin, K.E.A.; Mearin, M.L.; Murray, J.A.; Reilly, N.; Walker, M.M.; Sanders, D.S.; Shamir, R.; Troncone, R.; Husby, S.

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Authors

J.F. Ludvigsson

L. Agreus

C. Ciacci

S.E. Crowe

M.G. Geller

P.H.R. Green

I. Hill

A.P.S. Hungin

S. Koletzko

T. Koltai

K.E.A. Lundin

M.L. Mearin

J.A. Murray

N. Reilly

M.M. Walker

D.S. Sanders

R. Shamir

R. Troncone

S. Husby



Abstract

The process of transition from childhood to adulthood is characterised by physical, mental and psychosocial development. Data on the transition and transfer of care in adolescents/young adults with coeliac disease (CD) are scarce. In this paper, 17 physicians from 10 countries (Sweden, Italy, the USA, Germany, Norway, the Netherlands, Australia, Britain, Israel and Denmark) and two representatives from patient organisations (Association of European Coeliac Societies and the US Celiac Disease Foundation) examined the literature on transition from childhood to adulthood in CD. Medline (Ovid) and EMBASE were searched between 1900 and September 2015. Evidence in retrieved reports was evaluated using the Grading of Recommendation Assessment, Development and Evaluation method. The current consensus report aims to help healthcare personnel manage CD in the adolescent and young adult and provide optimal care and transition into adult healthcare for patients with this disease. In adolescence, patients with CD should gradually assume exclusive responsibility for their care, although parental support is still important. Dietary adherence and consequences of non-adherence should be discussed during transition. In most adolescents and young adults, routine small intestinal biopsy is not needed to reconfirm a childhood diagnosis of CD based on European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) or North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) criteria, but a biopsy may be considered where paediatric diagnostic criteria have not been fulfilled, such as, in a patient without biopsy at diagnosis, additional serology (endomysium antibody) has not been performed to confirm 10-fold positivity of tissue transglutaminase antibodies or when a no biopsy strategy has been adopted in an asymptomatic child.

Citation

Ludvigsson, J., Agreus, L., Ciacci, C., Crowe, S., Geller, M., Green, P., …Husby, S. (2016). Transition from childhood to adulthood in coeliac disease: the Prague consensus report. Gut, 65(8), 1242-1251. https://doi.org/10.1136/gutjnl-2016-311574

Journal Article Type Article
Acceptance Date Mar 27, 2016
Online Publication Date Apr 18, 2016
Publication Date Aug 1, 2016
Deposit Date May 5, 2016
Publicly Available Date May 5, 2016
Journal Gut
Print ISSN 0017-5749
Electronic ISSN 1468-3288
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 65
Issue 8
Pages 1242-1251
DOI https://doi.org/10.1136/gutjnl-2016-311574

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Publisher Licence URL
http://creativecommons.org/licenses/by-nc/4.0/

Copyright Statement
Advance online version This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/





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