How Important is Follow-up in Patients with Celiac Disease

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M Ulnes et al. JPGN 2023; 77: 640-647. Open Access! Lack of Follow-Up for Celiac Disease During Childhood Not Associated With Poor Health Outcomes: A Regional Swedish Cohort Study

In this Swedish cross-sectional cohort study with 162 children who had been diagnosed with celiac disease (CD) between 2013-2018, the authors examined the outcomes of children who had continued follow-up compared to those who had not been seen in 24 months. The average disease duration of study participants was 5.3 years.

Key findings:

  • Similar rates of TTG IgA normalization: 94% vs 91% for those without and those with follow-up respectively
  • Similar rates of very good dietary adherence 65% vs 72% for those without and those with follow-up respectively
  • Lack of follow-up was not significantly associated with growth, symptom scores, or HRQoL.

It is possible that there is a selection bias in that patients without symptoms may be less likely to followup.

My take: Based on this study, it looks like good education after diagnosis is crucial and that regular follow-up is less important in achieving good outcomes.

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