In coeliac disease effective long-term management and screening programs are lacking for children as well as for adults. In this thesis we tried to contribute to this close this gap. We showed that... Show moreIn coeliac disease effective long-term management and screening programs are lacking for children as well as for adults. In this thesis we tried to contribute to this close this gap. We showed that nutritional deficiencies present at diagnosis recover within 1 year of gluten-free diet and demonstrated that standard blood investigations besides coeliac specific serology are not necessary after 1 year of follow-up. Furthermore, the short dietary questionnaire developed by Biagi does not provide more information on diet adherence than coeliac specific antibodies, whereas a standardized dietary interview does. In the domain of screening, we demonstrated that parents from coeliac families support HLA-typing in their children in order to assess risk for the disease. Detailed information should be offered to them in order to prevent misinterpretation of the results, Antibody-testing should be offered to all HLA-DQ2 and/or DQ8 positive pediatric first degree relatives, with regular intervals until the age of 10. With regard to screening in asymptomatic diabetic children, normal duodenal mucosa is present in 12% of the children when biopsied in case of a TG2A titer of > 3xULN. Follow-up serology seems safe and appropriate in such cases. Show less
