{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:52:59Z","timestamp":1747187579793,"version":"3.40.5"},"reference-count":21,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2019,10,30]],"date-time":"2019-10-30T00:00:00Z","timestamp":1572393600000},"content-version":"vor","delay-in-days":29,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100008836","name":"Gaziantep \u00dcniversitesi","doi-asserted-by":"publisher","award":["TF.13.08"],"award-info":[{"award-number":["TF.13.08"]}],"id":[{"id":"10.13039\/501100008836","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The aim of this study was to assess the performance of a score\u2010based diagnostic approach (<jats:styled-content style=\"fixed-case\">SBDA<\/jats:styled-content>) proposed in the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (<jats:styled-content style=\"fixed-case\">ESPGHAN<\/jats:styled-content>) 2012 guideline, and the usefulness of bone mineral density (<jats:styled-content style=\"fixed-case\">BMD<\/jats:styled-content>) measurement in <jats:styled-content style=\"fixed-case\">SBDA<\/jats:styled-content> as an objective finding in the diagnosis of celiac disease (<jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The <jats:styled-content style=\"fixed-case\">SBDA<\/jats:styled-content> scores of 153 biopsy\u2010proven celiac diagnosed children (derived from symptomatology, serology, human leukocyte antigen [<jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content>] analysis, histology) were calculated. Additionally, <jats:styled-content style=\"fixed-case\">BMD<\/jats:styled-content> Z scores obtained at diagnosis were also investigated. The diagnostic sensitivity of <jats:styled-content style=\"fixed-case\">SBDA<\/jats:styled-content> was tested in different scenarios in which low <jats:styled-content style=\"fixed-case\">BMD<\/jats:styled-content> was scored as a diagnostic finding.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean age of children was 9.48 \u00b1 3.59\u00a0years and 54.2% were female. All patients scored \u22654, which is the minimum score to diagnose <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content> in <jats:styled-content style=\"fixed-case\">SBDA<\/jats:styled-content>. Mean <jats:styled-content style=\"fixed-case\">BMD<\/jats:styled-content> Z score in 142 of 153 patients was \u22122.70 \u00b1 1.16, and 73.9% of them were below \u22122. Moreover, different diagnostic scenarios without histology were tested. In one of them, <jats:styled-content style=\"fixed-case\">BMD<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content> were not included and the sensitivity was 85.2%. In another one, low <jats:styled-content style=\"fixed-case\">BMD<\/jats:styled-content> was scored as an equivalent of malabsorption, <jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content> was not included and sensitivity was 97.2%. The sensitivities of these scenarios were significantly different (<jats:italic>P<\/jats:italic> = 0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In the absence of both <jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content> and histology, accepting low <jats:styled-content style=\"fixed-case\">BMD<\/jats:styled-content> as an equivalent of malabsorption drastically increased the diagnostic sensitivity, while <jats:styled-content style=\"fixed-case\">SBDA<\/jats:styled-content> had limited success. Therefore, <jats:styled-content style=\"fixed-case\">BMD<\/jats:styled-content> might be useful when <jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content> and biopsy are not available.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ped.14002","type":"journal-article","created":{"date-parts":[[2019,9,5]],"date-time":"2019-09-05T10:09:45Z","timestamp":1567678185000},"page":"1015-1019","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Score\u2010based diagnostic approach to celiac disease and bone mineral density"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2238-188X","authenticated-orcid":false,"given":"Mehmet Enes","family":"Co\u015fkun","sequence":"first","affiliation":[{"name":"Department of Paediatrics University of Gaziantep Ankara Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6732-493X","authenticated-orcid":false,"given":"\u015eamil","family":"Hizli","sequence":"additional","affiliation":[{"name":"Department of Paediatric Gastroenterology, Hepatology and Nutrition Ankara Y\u0131ld\u0131r\u0131m Beyaz\u0131t University Ankara Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6768-238X","authenticated-orcid":false,"given":"Sibel","family":"Yavuz","sequence":"additional","affiliation":[{"name":"Department of Paediatric Gastroenterology, Hepatology and Nutrition Adana \u00c7ukurova University Adana Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8636-6641","authenticated-orcid":false,"given":"M\u00fcnevver Tu\u011fba","family":"Temel","sequence":"additional","affiliation":[{"name":"Department of Paediatrics University of Gaziantep Ankara Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,10,30]]},"reference":[{"doi-asserted-by":"publisher","key":"e_1_2_8_2_1","DOI":"10.1097\/MPG.0b013e31821a23d0"},{"doi-asserted-by":"publisher","key":"e_1_2_8_3_1","DOI":"10.1016\/j.cgh.2017.06.037"},{"doi-asserted-by":"publisher","key":"e_1_2_8_4_1","DOI":"10.1038\/ajg.2015.87"},{"doi-asserted-by":"publisher","key":"e_1_2_8_5_1","DOI":"10.1097\/MPG.0b013e318279887b"},{"doi-asserted-by":"publisher","key":"e_1_2_8_6_1","DOI":"10.1371\/journal.pone.0097853"},{"doi-asserted-by":"publisher","key":"e_1_2_8_7_1","DOI":"10.1053\/j.gastro.2017.06.002"},{"doi-asserted-by":"publisher","key":"e_1_2_8_8_1","DOI":"10.1093\/ajcn\/72.1.71"},{"doi-asserted-by":"publisher","key":"e_1_2_8_9_1","DOI":"10.1097\/00005176-200310000-00007"},{"doi-asserted-by":"publisher","key":"e_1_2_8_10_1","DOI":"10.1097\/00042737-199910000-00019"},{"doi-asserted-by":"publisher","key":"e_1_2_8_11_1","DOI":"10.1016\/j.jocd.2014.01.007"},{"doi-asserted-by":"publisher","key":"e_1_2_8_12_1","DOI":"10.1016\/j.jocd.2005.08.001"},{"doi-asserted-by":"publisher","key":"e_1_2_8_13_1","DOI":"10.1542\/peds.2016-2398"},{"doi-asserted-by":"publisher","key":"e_1_2_8_14_1","DOI":"10.1007\/s11154-007-9069-6"},{"doi-asserted-by":"publisher","key":"e_1_2_8_15_1","DOI":"10.1016\/j.bone.2010.06.008"},{"doi-asserted-by":"publisher","key":"e_1_2_8_16_1","DOI":"10.1542\/peds.108.5.e89"},{"doi-asserted-by":"publisher","key":"e_1_2_8_17_1","DOI":"10.1007\/s12098-016-2273-1"},{"doi-asserted-by":"publisher","key":"e_1_2_8_18_1","DOI":"10.1097\/MPG.0b013e31819ca18e"},{"doi-asserted-by":"publisher","key":"e_1_2_8_19_1","DOI":"10.1097\/MPG.0000000000001568"},{"doi-asserted-by":"publisher","key":"e_1_2_8_20_1","DOI":"10.5152\/tjg.2018.17451"},{"key":"e_1_2_8_21_1","first-page":"347","article-title":"Accuracy of HLA\u2010DQ genotyping in combination with IgA anti\u2010tissue transglutaminase serology and a \u201cscoring system\u201d for the diagnosis of celiac disease in Turkish children","volume":"56","author":"Cakir M","year":"2014","journal-title":"Turk. 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