{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T06:38:26Z","timestamp":1771655906816,"version":"3.50.1"},"reference-count":56,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2023,3,3]],"date-time":"2023-03-03T00:00:00Z","timestamp":1677801600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>The worldwide prevalence of asymptomatic coeliac disease (CD) is increasing, which is in part due to the routine screening of children with risk factors. Both symptomatic and asymptomatic patients with CD are at risk of long-term complications. The objective of this study was to compare the clinical characteristics of asymptomatic and symptomatic children at the time of CD diagnosis. A case\u2013control study was conducted using data from a cohort of 4838 CD patients recruited from 73 centers across Spain between 2011 and 2017. A total of 468 asymptomatic patients (cases) were selected and matched by age and sex with 468 symptomatic patients (controls). Clinical data, including any reported symptoms, as well as serologic, genetic, and histopathologic data were collected. No significant differences were found between the two groups in most clinical variables, nor in the degree of intestinal lesion. However, the asymptomatic patients were taller (height z-score \u22120.12 (1.06) vs. \u22120.45 (1.19), p &lt; 0.001) and were less likely to have anti transglutaminase IgA antibodies \u2265 10 times the upper normal limit (66.2% vs. 758.4%, p = 0.002). Among the 37.1% of asymptomatic patients who were not screened for CD due to the absence of risk factors, only 34% were truly asymptomatic, while the remaining 66% reported non-specific CD-related symptoms. Therefore, expanding CD screening to any child who undergoes a blood test could reduce the burden of care for some children, as many of those considered asymptomatic reported non-specific CD-related symptoms.<\/jats:p>","DOI":"10.3390\/nu15051267","type":"journal-article","created":{"date-parts":[[2023,3,6]],"date-time":"2023-03-06T01:35:30Z","timestamp":1678066530000},"page":"1267","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Coeliac Disease Case\u2013Control Study: Has the Time Come to Explore beyond Patients at Risk?"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6737-075X","authenticated-orcid":false,"given":"Gemma","family":"Castillejo","sequence":"first","affiliation":[{"name":"Unitat de Recerca en Pediatria, Hospital Universitari Sant Joan de Reus, Nutrici\u00f3 i Desenvolupament Hum\u00e0, IISPV, Universitat Rovira i Virgili, 43204 Reus, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7670-3699","authenticated-orcid":false,"given":"Carlos","family":"Ochoa-Sangrador","sequence":"additional","affiliation":[{"name":"Complejo Asistencial de Zamora, 49022 Zamora, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6018-3097","authenticated-orcid":false,"given":"David","family":"P\u00e9rez-Sol\u00eds","sequence":"additional","affiliation":[{"name":"Pediatrics, Hospital Universitario San Agust\u00edn, 33401 Avil\u00e9s, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Luz","family":"Cilleruelo","sequence":"additional","affiliation":[{"name":"Hospital Universitario Puerta de Hierro, Majadahonda, 28222 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ester","family":"Donat","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology and Hepatology Unit, Celiac Disease and Digestive Immunopathology Unit, Instituto de Investigaci\u00f3n Sanitaria La Fe, Hospital Universitari i Polit\u00e8cnic La Fe, 46026 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose Ignacio","family":"Garc\u00eda-Burriel","sequence":"additional","affiliation":[{"name":"Complejo Hospitalario Universitario de Vigo, 36312 Vigo, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F\u00e9lix","family":"S\u00e1nchez-Valverde","sequence":"additional","affiliation":[{"name":"Navarre Children\u2019s Nutrition and Digestive Study Group (GENDINA), Department of Paediatrics, NAVARRA BIOMED, University Hospital of Navarra, 31008 Pamplona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2811-0845","authenticated-orcid":false,"given":"Salvador","family":"Garcia-Calatayud","sequence":"additional","affiliation":[{"name":"Hospital Universitario Marques de Valdecilla, 39008 Santander, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco Javier","family":"Eizaguirre","sequence":"additional","affiliation":[{"name":"Paediatric Gastroenterology, Hepatology and Nutrition Unit, Hospital Universitario Donostia, 20006 San Sebastian, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva","family":"Martinez-Ojinaga","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology, Hospital Universitario La Paz, 28046 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2318-8512","authenticated-orcid":false,"given":"Patricia","family":"Barros","sequence":"additional","affiliation":[{"name":"Hospital San Pedro de Alc\u00e1ntara, 10071 C\u00e1ceres, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0540-4210","authenticated-orcid":false,"given":"Rosaura","family":"Leis","sequence":"additional","affiliation":[{"name":"Unit of Pediatrics Gastroenterology, Hepatology and Nutrition, Pediatrics Department, Hospital Cl\u00ednico Universitario de Santiago-USC, IDIS, CiberObn, 15706 Santiago de Compostela, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8725-0189","authenticated-orcid":false,"given":"Jose Carlos","family":"Salazar","sequence":"additional","affiliation":[{"name":"Hospital Universitario Infantil Virgen del Roc\u00edo, 41013 Sevilla, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6103-2191","authenticated-orcid":false,"given":"Josefa","family":"Barrio","sequence":"additional","affiliation":[{"name":"Hospital Universitario de Fuenlabrada, Fuenlabrada, 28942 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6052-5894","authenticated-orcid":false,"given":"Luis","family":"Pe\u00f1a-Quintana","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology, Hepatology and Nutrition Unit, Complejo Hospitalario Universitario Insular Materno-Infantil, CIBEROBN ISCIII-Universidad de Las Palmas de Gran Canaria, 35016 Gran Canaria, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2615-8175","authenticated-orcid":false,"given":"Ver\u00f3nica","family":"Luque","sequence":"additional","affiliation":[{"name":"Unitat de Recerca en Pediatria, Nutrici\u00f3 i Desenvolupament Hum\u00e0, Universitat Rovira i Virgili, 43007 Tarragona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabel","family":"Polanco","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology, Hospital Universitario La 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