{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T20:14:48Z","timestamp":1777493688977,"version":"3.51.4"},"reference-count":40,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2009,12,1]]},"abstract":"<jats:p>OBJECTIVE: The goal was to evaluate the impact of immunoglobulin A endomysial antibody testing on the incidence and clinical presentation of childhood celiac disease.<\/jats:p>\n               <jats:p>METHODS: The incidence and clinical presentation of celiac disease in patients &amp;lt;18 years of age in 1990\u20131996 (pretesting group) versus 2000\u20132006 (testing group) were compared.<\/jats:p>\n               <jats:p>RESULTS: The median age at diagnosis was 2 years (95% confidence interval: 2\u20134 years) in the pretesting group (N = 36), compared with 9 years (95% confidence interval: 8\u201310 years) in the testing group (N = 199; P &amp;lt; .001); the female\/male ratios (1.6:1) were similar (P = .982). The incidence of celiac disease increased from 2.0 cases per 100000 children (pretesting group) to 7.3 cases per 100000 children (testing group; P = .0256). The frequency of classic celiac disease presentations decreased from 67% (pretesting group) to 19% (testing group; P &amp;lt; .001), but the incidence of classic celiac disease did not differ (0.8 vs 1.6 cases per 100000; P = .154). In the testing group, 13 previously unrecognized clinical presentations were observed in 98 children, including 35 with family history, 18 with abdominal pain, and 14 with type 1 diabetes mellitus. The frequency of Marsh IIIc lesions decreased from 64% (pretesting group) to 44% (testing group; P = .0403). In the testing group, classic celiac disease remained predominant (67%) in young children (&amp;lt;3 years), whereas atypical gastrointestinal and silent presentations predominated in older children.<\/jats:p>\n               <jats:p>CONCLUSIONS: Antibody testing for celiac disease tripled the incidence of celiac disease and quadrupled the median age at diagnosis.<\/jats:p>","DOI":"10.1542\/peds.2008-2373","type":"journal-article","created":{"date-parts":[[2009,11,30]],"date-time":"2009-11-30T12:27:49Z","timestamp":1259584069000},"page":"1572-1578","source":"Crossref","is-referenced-by-count":103,"title":["The Changing Face of Childhood Celiac Disease in North America: Impact of Serological Testing"],"prefix":"10.1542","volume":"124","author":[{"given":"Kelly E.","family":"McGowan","sequence":"first","affiliation":[{"name":"Department of Pediatrics, University of Calgary, Calgary, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Derek A.","family":"Castiglione","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Calgary, Calgary, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. Decker","family":"Butzner","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Calgary, Calgary, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2009,12,1]]},"reference":[{"key":"2021120905213061500_R1","doi-asserted-by":"crossref","unstructured":"Fasano A. Clinical presentation of celiac disease in the pediatric population. Gastroenterology.\u20082005;128(4 suppl 1):S68\u2013S73","DOI":"10.1053\/j.gastro.2005.02.015"},{"key":"2021120905213061500_R2","doi-asserted-by":"crossref","unstructured":"Fasano A, Berti I, Gerarduzzi T, et al. Prevalence of celiac disease in at-risk and not-at-risk groups in the United States: a large multicenter study. Arch Intern Med.\u20082003;163(3):286\u2013292","DOI":"10.1001\/archinte.163.3.286"},{"key":"2021120905213061500_R3","doi-asserted-by":"crossref","unstructured":"Rewers M. 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