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Gut. 2016 Aug;65(8):1242-51. doi: 10.1136/gutjnl-2016-311574. Epub 2016 Apr 18.

Transition from childhood to adulthood in coeliac disease: the Prague consensus report.

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  • 1Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden Department of Paediatrics, Örebro University Hospital, Örebro, Sweden Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK.
  • 2Division of Family Medicine, Karolinska Institutet, Sweden.
  • 3Department of Medicine and Surgery, University of Salerno, Salerno, Italy.
  • 4University of California, San Diego (UCSD), San Diego, California, USA.
  • 5Celiac Disease Foundation, Los Angeles, California, USA.
  • 6Celiac Disease Center at Columbia University, New York, New York, USA.
  • 7Division of Gastroenterology, Nationwide Children's Hospital, Columbus, Ohio, USA.
  • 8Primary Care and General Practice, School of Medicine, Pharmacy and Health, Durham University, Stockton on Tees, UK.
  • 9Ludwig-Maximilians-University of Munich, Dr. von Hauner Children's Hospital, Munich, Germany.
  • 10Hungary (for the Association of European Coeliac Societies, AOECS), Budapest, Hungary.
  • 11Department of Gastroenterology and Centre for Immune Regulation, Oslo University Hospital Rikshospitalet, Oslo, Norway.
  • 12Department of Paediatrics, Leiden University Medical Center, Leiden, The Netherlands.
  • 13Division of Gastroenterology and Hepatology, Department of Immunology Mayo Clinic, Rochester, Minnesota, USA.
  • 14Columbia University Medical Center-Division of Paediatric Gastroenterology, New York, New York, USA.
  • 15Anatomical Pathology, Faculty of Health and Medicine, University of Newcastle, School of Medicine & Public Health, Newcastle, Australia.
  • 16Academic Unit of Gastroenterology, Royal Hallamshire Hospital & University of Sheffield, Sheffield, UK.
  • 17Institute of Gastroenterology, Nutrition and Liver Diseases Schneider Children's Medical Center of Israel, Tel-Aviv University, Tel Aviv, Israel.
  • 18Department of Medical Translational Sciences & European Laboratory for the Investigation of Food Induced Diseases, University Federico II, Naples, Italy.
  • 19Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense C, Denmark.


The process of transition from childhood to adulthood is characterised by physical, mental and psychosocial development. Data on the transition and transfer of care in adolescents/young adults with coeliac disease (CD) are scarce. In this paper, 17 physicians from 10 countries (Sweden, Italy, the USA, Germany, Norway, the Netherlands, Australia, Britain, Israel and Denmark) and two representatives from patient organisations (Association of European Coeliac Societies and the US Celiac Disease Foundation) examined the literature on transition from childhood to adulthood in CD. Medline (Ovid) and EMBASE were searched between 1900 and September 2015. Evidence in retrieved reports was evaluated using the Grading of Recommendation Assessment, Development and Evaluation method. The current consensus report aims to help healthcare personnel manage CD in the adolescent and young adult and provide optimal care and transition into adult healthcare for patients with this disease. In adolescence, patients with CD should gradually assume exclusive responsibility for their care, although parental support is still important. Dietary adherence and consequences of non-adherence should be discussed during transition. In most adolescents and young adults, routine small intestinal biopsy is not needed to reconfirm a childhood diagnosis of CD based on European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) or North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) criteria, but a biopsy may be considered where paediatric diagnostic criteria have not been fulfilled, such as, in a patient without biopsy at diagnosis, additional serology (endomysium antibody) has not been performed to confirm 10-fold positivity of tissue transglutaminase antibodies or when a no biopsy strategy has been adopted in an asymptomatic child.



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