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FIRST DRAFT OF THE RETROSPECTIVE STUDY
Workshop MEDICELThe Mediterranean Network for Celiac Disease
III Progress MeetingPastaTrend, BolognaFiere
Bologna, April 5th 2011
RETROSPECTIVE STUDY • AIM: To evaluate the presence of the markers
required for the new ESPGHAN protocol in 50 unselected consecutive patients in each country
• 10 countries: Albania, Bosnia H, Croatia, France, Greece, Italy (Naples), Italy (Sicily), Morocco, Slovenia, Turkey
• ESPECTED RESULTS:• To estimate the percentage of patients who bear the
markers required by the new approach• To produce a quite original picture of the CD
diagnosis in the area
498 cases
DATA REQUIRED• Date of birth• Date of diagnosis• Sex• Biopsy results• Anti TGase (UI)• HLA genotype• 3 symptoms• Familiarity• Associated disease• Treatment
Statistics
498 460 177 128 133
0 38 321 370 365
Valid
Missing
NSEX BIOPSY HLA FAMIL ASSOC
AGE AT DIAGNOSISAGE5
AGE5
3,002,001,00,00
Fre
qu
en
cy
300
200
100
0
46,5%
32%
16,6%
4,9%
0-4 y 5-9 y 10-14 y 15-22 y
AGE AT DIAGNOSIS/COUNTRY
COUNTRY
BOSNIA
SLOVENIA
SICILY
FRANCE
MOROCCO
ITALY
TURKEY
CROATIA
GREECE
Co
un
t60
50
40
30
20
10
0
AGE5
,00
1,00
2,00
3,00
0-4 y
5-9 y
10-14 y
15-22 y
HLA
HLA
NODQ2/8DQ2/8DQ8DQ2
Fre
qu
en
cy
160
140
120
100
80
60
40
20
0
74%
6,7%
16,3%
2,8%
Statistics
498 460 177 128 133
0 38 321 370 365
Valid
Missing
NSEX BIOPSY HLA FAMIL ASSOC
64,4% NOT Genotyped
FAMILIARITY
FAMIL
FAMIL
MORE THAN ONESIBDADMOM
Fre
qu
en
cy
40
30
20
10
0
28,2%
30,6%
17,7%
23,4%
Frequency Percent
%
Familiarity 128 25,7
NO Familiarity
370 74,3
ASSOCIATED DISEASESASSOC
ASSOC
OTHER
EPILEPSY
LIVER
DOWN
IDDM1
IGA DEF
DERM HERP
THYROID
Fre
qu
en
cy
70
60
50
40
30
20
10
0
11,4%
2,4%1,8%
4,8%
0,6%1,6%
0,4%
3,6%
73,3% No associated diseases
BIOPSY
BIOPSY
T3CT3BT3AT2T1T0
Fre
qu
en
cy
300
200
100
0
BIOPSY RESULTS
NOT DONE = 7,6%
3% 4,3%7%
14,3%
23,7%
45,7%
ANTI-TGASE LEVELS AND BIOPSY
132633616188N =
BIOPSY
T3CT3BT3AT2T1T0
TG
AS
E
250
200
150
100
50
0
148127
TGASEQUA
150,00100,0050,00
Co
un
t160
140
120
100
80
60
40
20
0
BIOGR
2,00
5,00
NO Atrophy
Atrophy
ANTI-TGASE LEVELS AND BIOPSY
<50 UI 50-100 UI >100 UI
LIMITATIONS
1. Selection bias
2. Bad management of the missing data: • Uncompleted files
3. Anti TGase: • Meaning of the NEGATIVE results• Lack of standardization
4. Biopsy: • Lack of standardization
LIMITATIONSCase Processing Summary
50 100,0% 0 ,0% 50 100,0%
50 100,0% 0 ,0% 50 100,0%
48 96,0% 2 4,0% 50 100,0%
63 100,0% 0 ,0% 63 100,0%
50 100,0% 0 ,0% 50 100,0%
49 98,0% 1 2,0% 50 100,0%
50 100,0% 0 ,0% 50 100,0%
50 100,0% 0 ,0% 50 100,0%
34 81,0% 8 19,0% 42 100,0%
16 37,2% 27 62,8% 43 100,0%
COUNTRYGREECE
CROATIA
TURKEY
ITALY
MOROCCO
FRANCE
SICILY
SLOVENIA
BOSNIA
Albania
BIOPSYN Percent N Percent N Percent
Valid Missing Total
Cases
FUTURE PROSPECTS
• Prospective study for 6 months (50 cases/country) to evaluate the applicability of the new ESPGHAN protocol
• A positive evaluation of the new protocol could reduce the confinement of the diagnosis to specialized centres only