Survey of the initial management of celiac disease antibody tests by ordering physicians.

Background: Appropriate interpretation of a positive celiac antibody test by an ordering physician is important in order to institute proper management. We evaluated why children with an initial positive celiac serology were not referred for diagnostic biopsy or followed with serial testing by the ordering physician.

Methods: Consecutive celiac serologies in all patients less than 18 years of age were evaluated over 3.

Management of bone health in patients with celiac disease: Practical guide for clinicians.

Objective: To describe clinical issues related to bone health in patients with celiac disease (CD) and to provide guidance on monitoring bone health in these patients.

Sources Of Information: A PubMed search was conducted to review literature relevant to CD and bone health, including guidelines published by professional gastroenterological organizations.

Main Message: Bone health can be negatively affected in both adults and children with CD owing to the inflammatory process and malabsorption of calcium and vitamin D.

Normalization Time of Celiac Serology in Children on a Gluten-free Diet.

Objectives: Response to a gluten-free diet (GFD) in children with celiac disease is determined by symptom resolution and normalization of serology. We evaluated the rate of normalization of the transglutaminase (TTG) and antiendomysial (EMA) for children on a GFD after diagnosis.

Methods: Celiac serologies were obtained over 3.

Evidence-Informed Expert Recommendations for the Management of Celiac Disease in Children.

Although the need for effective long-term follow-up for patients with celiac disease (CD) has been recognized by many expert groups, published practice guidelines have not provided a clear approach for the optimal management of these patients. In an attempt to provide a thoughtful and practical approach for managing these patients, a group of experts in pediatric CD performed a critical review of the available literature in 6 categories associated with CD to develop a set of best practices by using evidence-based data and expert opinion. The 6 categories included the following: bone health, hematologic issues, endocrine problems, liver disease, nutritional issues, and testing.

Evaluation of the ESPGHAN Celiac Guidelines in a North American Pediatric Population.

Objectives: We retrospectively examined the performance of the tissue transglutaminase (TTG), endomysial antibody (EMA) tests, and the ESPGHAN (European Society of Paediatric Gastroenterology, Hepatology and Nutrition) nonbiopsy criteria in a pediatric population.

Methods: Consecutive celiac serologies and corresponding intestinal biopsy results were obtained on children <18 years old over 3.5 years.

Consensus statements on the risk, prevention, and treatment of venous thromboembolism in inflammatory bowel disease: Canadian Association of Gastroenterology.

Background & Aims: Guidelines for the management of venous thromboembolism (VTE) from the American College of Chest Physicians do not address patients with inflammatory bowel disease (IBD), a group with a high risk of both VTE and gastrointestinal bleeding. We present recommendations for the prevention and treatment of VTE in patients with IBD.

Methods: A systematic literature search was performed to identify studies on VTE in IBD.

A pilot study examining the relationship among Crohn disease activity, glucagon-like peptide-2 signalling and intestinal function in pediatric patients.

Unlabelled: BACKGROUND⁄

Objectives: The relationship between the enteroendocrine hormone glucagon-like peptide 2 (GLP-2) and intestinal inflammation is unclear. GLP-2 promotes mucosal growth, decreases permeability and reduces inflammation in the intestine; physiological stimulation of GLP-2 release is triggered by nutrient contact. The authors hypothesized that ileal Crohn disease (CD) affects GLP-2 release.

Incidence and prevalence of eosinophilic esophagitis in children.

Objectives: The aim of the present study was to conduct a systematic review with meta-analysis on the epidemiology of eosinophilic esophagitis (EoE) in children.

Methods: Studies investigating incidence and prevalence of EoE in children (≤ 18 years) were identified in a systematic review of MEDLINE (1950-2011) and Embase (1980-2011). Meta-analyses were performed for incidence and subgroups with ≥ 5 studies: esophagogastroduodenoscopy (EGD) for any indication, histologic esophageal disease, and celiac disease, and EGD for abdominal pain.

Therapeutic applications of octreotide in pediatric patients.

Background/aim: We report our experience with the use of octreotide as primary or adjunctive therapy in children with various gastrointestinal disorders.

Patients And Methods: A pharmacy database identified patients who received octreotide for gastrointestinal diseases. Indications for octreotide use, dosing, effectiveness, and adverse events were evaluated by chart review.

Kabuki syndrome and Crohn disease in a child with familial hypocalciuric hypercalcemia.

Background: Familial hypocalciuric hypercalcemia (FHH) results from a mutation of the calcium sensing receptor (CASR) gene and typically presents as asymptomatic hypercalcemia with inappropriately low urinary calcium excretion and normal or mildly elevated levels of parathyroid hormone.

Objective: To describe a case of FHH associated with Kabuki syndrome and Crohn disease.

Method: Genomic DNA was screened for CASR mutations and a retrospective chart review was performed.

The changing face of childhood celiac disease in north america: impact of serological testing.

Objective: The goal was to evaluate the impact of immunoglobulin A endomysial antibody testing on the incidence and clinical presentation of childhood celiac disease.

Methods: The incidence and clinical presentation of celiac disease in patients <18 years of age in 1990-1996 (pretesting group) versus 2000-2006 (testing group) were compared.

Results: The median age at diagnosis was 2 years (95% confidence interval: 2-4 years) in the pretesting group (N = 36), compared with 9 years (95% confidence interval: 8-10 years) in the testing group (N = 199; P < .

Home blood testing for celiac disease: recommendations for management.

Objective: To provide recommendations for the management of patients who inquire about the Health Canada-approved, self-administered home blood tests for celiac disease or who present with positive test results after using the self-testing kit

Sources Of Information: PubMed and the Cochrane Database of Systematic Reviews were searched from January 1985 to April 2008, using the subject headings diagnosis of celiac disease and management or treatment of celiac disease. Guidelines for serologic testing and confirmation of diagnosis of celiac disease by the American Gastroenterological Association and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition are used in this review. Level 1 evidence was used.

Celiac disease and IgA deficiency: complications of serological testing approaches encountered in the clinic.

Background: IgA deficiency causes false-negative IgA-based celiac serology results in patients with celiac disease. Using a case-finding strategy, we examined the prevalence of IgA deficiency, physician evaluation, and management of IgA deficiency during serological testing for celiac disease.

Methods: We reviewed consecutive IgA-endomysial antibody (EMA) and serum IgA results from the laboratory database over 17 months.

Biliary atresia: the Canadian experience.

Objective: To determine the outcomes of Canadian children with biliary atresia.

Study Design: Health records of infants born in Canada between January 1, 1985 and December 31, 1995 (ERA I) and between January 1, 1996 and December 31, 2002 (ERA II) who were diagnosed with biliary atresia at a university center were reviewed.

Results: 349 patients were identified.

Consumption of pure oats by individuals with celiac disease: a position statement by the Canadian Celiac Association.

The treatment of celiac disease is a strict adherence to a gluten-free diet for life. In the past, oats were considered to be toxic to individuals with celiac disease and were not allowed in a gluten-free diet. However, recent evidence suggests that oats that are pure and uncontaminated with other gluten-containing grains, if taken in limited quantities, are safe for most individuals with celiac disease.

Celiac disease: are endomysial antibody test results being used appropriately?

Background: The aim of this study was to retrospectively examine how positive IgA-endomysial antibody (EMA) test results for celiac disease were being interpreted and acted on by physicians in the Calgary Health Region.

Methods: We reviewed consecutive EMA test results, with or without a serum IgA, obtained during a 17-month period. Seropositive tests were cross-referenced to the surgical database to determine the number of patients who underwent intestinal biopsy and the results of the biopsy.

The Canadian Celiac Health Survey.

The purpose of this study was to characterize the diagnostic process, frequency of associated disorders, family history, and impact of a gluten-free diet in individuals with celiac disease. All members of the Canadian Celiac Association (n=5240) were surveyed with a questionnaire. Respondents included 2681 adults with biopsy-proven celiac disease.

The burden of large and small duct primary sclerosing cholangitis in adults and children: a population-based analysis.

Objectives: The epidemiology of primary sclerosing cholangitis (PSC) has been incompletely assessed by population-based studies. We therefore conducted a population-based study to determine: (a) incidence rates of large and small duct PSC in adults and children, (b) the risk of inflammatory bowel disease on developing PSC, and (c) patterns of clinical presentation with the advent of magnetic resonance cholangiopancreatography (MRCP).

Methods: All residents of the Calgary Health Region diagnosed with PSC between 2000 and 2005 were identified by medical records, endoscopic, diagnostic imaging, and pathology databases.

Celiac disease: evaluation of the diagnosis and dietary compliance in Canadian children.

Objectives: We sought to characterize the clinical features at presentation as well as the associated disorders, family history, and evaluation of compliance with a gluten-free diet in children with celiac disease from across Canada.

Study Design: All members (n = 5240) of the Canadian Celiac Association were surveyed with a questionnaire. Of the 2849 respondents with biopsy-confirmed celiac disease, 168 who were < 16 years old provided the data reported here.

Crohn's disease and cheilitis.

A five-year-old boy presented to his family physician with painless swelling of both lips. One year later he developed abdominal pain, nonbloody diarrhea, weight loss and joint pains. Colonoscopic examination demonstrated patchy erythema, friability and multiple aph-thous ulcers consistent with the appearance of Crohn's colitis, and treatment with prednisone was initiated.