ESPGHAN Position Paper on Management and Follow-up of Children and Adolescents With Celiac Disease

M L Mearin*, D Agardh, H Antunes, A Al-Toma, R Auricchio, G Castillejo, C Catassi, C Ciacci, V Discepolo, J Dolinsek, E Donat, P Gillett, S Guandalini, S Husby, S Koletzko, T Koltai, I R Korponay-Szabó, K Kurppa, E Lionetti, K MårildE Martinez Ojinaga, C Meijer, C Monachesi, I Polanco, A Popp, M Roca, A Rodriguez-Herrera, R Shamir, K Stordal, R Troncone, F Valitutti, A Vreugdenhil, M Wessels, P Whiting, ESPGHAN Special Interest Group on Celiac Disease

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

10 Citations (Web of Science)
97 Downloads (Pure)


AIM: To gather the current evidence and to offer recommendations for follow-up and management.

METHODS: The Special Interest Group on Coeliac Diseases of the European Society of Paediatric Gastroenterology Hepatology and Nutrition formulated ten questions considered to be essential for follow-up care. A literature search (January 2010 - March 2020) was performed in PubMed or Medline. Relevant publications were identified and potentially eligible studies were assessed. Statements and recommendations were developed and discussed by all co-authors. Recommendations were voted upon: joint agreement was set as at least 85%.

RESULTS: Publications (n=2775) were identified and 164 were included. Using evidence and/or expert opinion, 37 recommendations were formulated on: The need to perform follow-up, its frequency and what should be assessed, how to assess adherence to the gluten-free diet, when to expect catch-up growth, how to treat anaemia, how to approach persistent high serum levels of antibodies against tissue-transglutaminase, the indication to perform biopsies, assessment of quality of life, management of children with unclear diagnosis for which a gluten challenge is indicated, children with associated type 1 diabetes or IgA deficiency, cases of potential coeliac disease, which professionals should perform follow-up, how to improve the communication to patients and their parents/caregivers and transition from paediatric to adult health-care.

CONCLUSIONS: We offer recommendations to improve follow-up of children and adolescents with coeliac disease and highlight gaps that should be investigated to further improve management.

Original languageEnglish
Pages (from-to)369-386
Number of pages18
JournalJournal of Pediatric Gastroenterology and Nutrition
Issue number3
Early online date27 Jun 2022
Publication statusPublished - Sept 2022


  • celiac disease
  • children and adolescents
  • follow-up
  • position paper European Society of Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN)

Cite this