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‘Coeliac disease diagnosis is often overlooked or delayed’

Although coeliac disease, an autoimmune disorder that makes you gluten intolerant, occurs in 1% of the population, its diagnosis is often delayed or completely overlooked. To prevent health problems, this must change. That is what Professor of Paediatrics Luisa Mearin said at her inaugural lecture on Friday 21 February 2020.

Coeliac disease, or gluten intolerance as it is also known, is easy to diagnose nowadays. Mearin: ‘We have tests that take only ten minutes to detect specific coeliac antibodies in a single drop of blood. I often call it the pregnancy test for coeliac disease,’ Mearin explains. She was appointed as Professor Paediatrics in July 2019, with a particular focus on coeliac disease and other chronic inflammatory bowel disorders.

Screening at child health clinics

Mearin is using the quick blood test for coeliac disease in the GLUTENSCREEN [in Dutch] research project into early detection of the disease. In this project she is working together with the child health clinics of the Youth Health Care Service in the Kennemerland region. All parents of children aged between of one and four complete a questionnaire on the ten symptoms that are associated with coeliac disease, such as chronic stomach ache, chronic diarrhoea, stomach bloating and poor growth. If the child has one or more of these symptoms and its parents give informed consent, the quick blood test is carried out at the child health care clinic. If the results are positive, the child is referred to the coeliac clinic at the LUMC for a definitive diagnosis and treatment.

Early diagnosis

Researchers on the GLUTENSCREEN project are analysing whether this form of secondary prevention is effective and achievable. The initial results are positive. ‘We had expected to find coeliac disease in one in 100 children, but this now proves to be two in 100,’ says Mearin. Early diagnosis is important, so the child can start a gluten-free diet immediately. ‘Children with untreated coeliac disease have chronic inflammation of the bowel and are at significant risk of osteoporosis, growth delay and behavioural problems. What is more, it’s easier to start a gluten-free diet at an early age.’ If the results of the GLUTENSCREEN project are positive, Professor Mearin will call for a national programme for early screening for coeliac disease.

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