………….

Aydan Kansu, MDAnkara University School of Medicine, Department of Pediatric Gastroenterology andHepatology, Turkey

Building National Task ForceBuilding National Task Force

National representative

Ministry of Health(Head of non-infectious diseases and chronic diseases)

Turkish Society of Pediatric Gastroenterology and Hepatology

Celiac Society (Ankara)

Training and Dissemination at National Level – 1Training and Dissemination at National Level – 1

Universities, School of Medicine

Pediatrics residency training programmecurriculum 20/01/2011– Chronic abdominal pain– Chronic constipation– GER– Chronic liver diseases – liver failure– Malabsorption – Celiac disease– Malnutrition

Pediatric gastroenterology fellowship training programme

Training and Dissemination at National Level - 2Training and Dissemination at National Level - 2

Family doctors (GP)– Distant Training (Celiac module)

(Ministry of Health)– Regional Seminars (proposed)

(Turkish Society of Pediatric Gastroenterology and Hepatology)

Pediatricians– Regional Seminars (proposed)

(Turkish Society of Pediatric Gastroenterology and Hepatology)

– Congress – Meetings– Distant Training (proposed)

Training and Dissemination at National Level – 3Training and Dissemination at National Level – 3

For the society

– Radio-TV (proposed)(Turkish Society of Pediatric Gastroenterology and Hepatology)(Celiac Society)

– Parenthood Education (proposed)(Ankara University School of Medicine, Department of Pediatrics)

– Elementary Schoolscurriculum (3rd and 5th grade) 09/2010

Diagnostic GuidelinesDiagnostic Guidelines

Transglutaminase

HLA (not widely available)

Endoscopic bx (managed)

Retrospective StudyRetrospective Study

tg levels – bx: correlated

HLA: 26/50 DQ2

3/50 DQ8

3/50 DQ2 + DQ8

3/50 no DQ2 / DQ8

AJG-10-1661.R2

PREVALENCE OF CELIAC DISEASE IN HEALTHY TURKISH SCHOOL CHILDREN

Dear Dr. Sari

Thank you for submitting your revised manuscript. Your revised manuscript has been reviewed, and the Editors and Editorial Board are pleased to accept it for publication in a future issue of the Journal.

Yours sincerely,

Dr. Joseph MurrayAssociate Editor

William Chey, MDPaul Moayyedi, MDEditors-in-Chief

01.02.2011

Turkish Celiac Study Group - 1Turkish Celiac Study Group - 1

20.190 children from 139 schools in 62 cities

489 ab+ IgA tTG +: 270IgA tTG + IgA EMA +: 215IgG tTG +: 4

215 bx 95 CDHistology IgA tTGMarsh O 43.3 (28.6-81.6)Marsh I (n:18) 115.2 (59.3-198)Marsh II (n:6) 120.6 (26.8-220)Marsh III (n:71) 220 (199.2-220)

Turkish Celiac Study Group - 2Turkish Celiac Study Group - 2

Histopathological grade was correlated with IgA tTG titer (p<0.0001)

IgA EMA (+) patients had higher IgA tTG titer

The best PPV (88.73%) for IgA tTG was found when cutt off: 180 RU/ml (9xULN)

bx proven prevalence of CD 1:212

estimated prevalence of CD 1:58(bx + already diagnosed + tTG + EMA)

serologic positivity 1:41

Pilot StudyPilot Study

URFA

State Hospital

Pediatric gastroenterologist (obligatory work)

Very big family size (10-12 children/family)

Very high rate of gluten consuming

tg available

bx will be referred

Risk FactorsRisk Factors

Genetic

Biological samples

DNA

PROBLEMPROBLEM

Celiac AssociationCeliac Association

~ 12.000 celiac patients in Turkey

CA– Ankara (400) – very active

– İstanbul

– Bursa

– Konya

– Kayseri

– Diyarbakır

– Gaziantep

Gluten Free DietGluten Free Diet

01.03.2011

0-5 y: 52.50 TL (28 €)

5-15 y: 80 TL (36 €)

15 y : 72.50 TL (33 €)

flour : 7.6 €/kgpasta : 13.2 €/kg