{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T07:05:41Z","timestamp":1765609541487},"reference-count":41,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2013,2,1]],"date-time":"2013-02-01T00:00:00Z","timestamp":1359676800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. pediatr. gastroenterol. nutr."],"published-print":{"date-parts":[[2013,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background and Aim:<\/jats:title><jats:p>To diagnose coeliac disease (CD) in children younger than 2 years, the old ESPGHAN criteria based on 3 small bowel biopsies were recommended until recently. The aim of the present study was to investigate the applicability of only 1 small intestinal biopsy plus positive serology for the diagnosis of CD in children younger than 2 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p>A prospective cohort study included 81 patients younger than 2 years with symptoms suggestive of CD, who all completed the diagnostic procedure based on 3 small bowel biopsies. According to the finding of the third biopsy, patients were divided into group A\u2014CD confirmed (N = 44), and group B\u2014CD not confirmed, after the gluten challenge (N = 37).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>At the time of the first biopsy, total villous atrophy (Marsh IIIc) was found more often in group A than in group B (77% vs 27%, <jats:italic>P<\/jats:italic> &lt; 0.01). Also, all of the studied antibodies were more frequently positive in group A than in group B (<jats:italic>P<\/jats:italic> &lt; 0.01 for all of the tested antibodies). Positive anti\u2010endomysial antibodies and Marsh IIIc finding were the best discriminators between the group A and the group B and considerably contributed to the prediction of CD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p>The second and the third biopsies (before and after the gluten challenge) may also be avoided when diagnosing CD in children younger than 2 years provided that the child, at the time of presentation, has positive anti\u2010endomysial antibodies and Marsh IIIc on the small bowel biopsy. A gluten challenge should be still considered in all other children younger than 2 years.<\/jats:p><\/jats:sec>","DOI":"10.1097\/mpg.0b013e3182716861","type":"journal-article","created":{"date-parts":[[2013,1,16]],"date-time":"2013-01-16T10:47:48Z","timestamp":1358333268000},"page":"201-205","source":"Crossref","is-referenced-by-count":9,"title":["Diagnosis of Coeliac Disease in Children Younger Than 2 Years"],"prefix":"10.1002","volume":"56","author":[{"given":"Zrinjka","family":"Mi\u0161ak","sequence":"first","affiliation":[{"name":"Referral Centre for Paediatric Gastroenterology and Nutrition Children's Hospital Zagreb Zagreb Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iva","family":"Hojsak","sequence":"additional","affiliation":[{"name":"Referral Centre for Paediatric Gastroenterology and Nutrition Children's Hospital Zagreb Zagreb 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