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Volume 14
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Study Protocol

Recognizing the Emergent and Submerged Iceberg of the Celiac Disease: ITAMA Project—Global Strategy Protocol

by
Giuseppe Magazzù
1,*,
Samuel Aquilina
2,
Christopher Barbara
3,
Ramon Bondin
2,
Ignazio Brusca
4,
Jacqueline Bugeja
5,
Mark Camilleri
3,
Donato Cascio
6,
Stefano Costa
7,
Chiara Cuzzupè
1,
Annalise Duca
5,
Maria Fregapane
4,
Vito Gentile
6,
Angele Giuliano
5,
Alessia Grifò
1,
Anne-Marie Grima
2,
Antonio Ieni
1,
Giada Li Calzi
6,
Fabiana Maisano
1,
Giuseppinella Melita
1,
Socrate Pallio
8,
Ilenia Panasiti
1,
Salvatore Pellegrino
7,
Claudio Romano
1,
Salvatore Sorce
6,9,
Marco Elio Tabacchi
10,
Vincenzo Taormina
6,
Domenico Tegolo
10,
Andrea Tortora
11,
Cesare Valenti
10,
Cecil Vella
2 and
Giuseppe Raso
6add Show full author list remove Hide full author list
1
Dipartimento di Patologia Umana dell’Adulto e dell’Età Evolutiva “Gaetano Barresi”, Università di Messina, 98122 Messina, Italy
2
Department of Paediatrics, Mater Dei Hospital, 2090 Msida, Malta
3
Department of Pathology, Mater Dei Hospital, 2090 Msida, Malta
4
Ospedale Fatebenefratelli, Buccheri La Ferla, 90123 Palermo, Italy
5
AcrossLimits Ltd., 4013 Birkirkara, Malta
6
Dipartimento di Fisica e Chimica-“E. Segrè”, Università di Palermo, 90133 Palermo, Italy
7
DAI Materno-Infantile, AOU Policlinico G. Martino, 98124 Messina, Italy
8
Dipartimento di Medicina Clinica e Sperimentale, Università di Messina, 98122 Messina, Italy
9
Facoltà di Ingegneria e Architettura, Università degli Studi di Enna “Kore”, 94100 Enna, Italy
10
Dipartimento di Matematica e Informatica, Università di Palermo, 90133 Palermo, Italy
11
DAI Scienze Mediche, AOU Policlinico G. Martino, 98124 Messina, Italy
 
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*
Author to whom correspondence should be addressed.
Pediatr. Rep. 2022, 14(2), 293-311; https://doi.org/10.3390/pediatric14020037
Submission received: 30 March 2022 / Revised: 19 May 2022 / Accepted: 6 June 2022 / Published: 10 June 2022
(This article belongs to the Special Issue Feature Papers in Pediatric Reports)
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Abstract

Coeliac disease (CD) is frequently underdiagnosed with a consequent heavy burden in terms of morbidity and health care costs. Diagnosis of CD is based on the evaluation of symptoms and anti-transglutaminase antibodies IgA (TGA-IgA) levels, with values above a tenfold increase being the basis of the biopsy-free diagnostic approach suggested by present guidelines. This study showcased the largest screening project for CD carried out to date in school children (n=20,000) aimed at assessing the diagnostic accuracy of minimally invasive finger prick point-of-care tests (POCT) which, combined with conventional celiac serology and the aid of an artificial intelligence-based system, may eliminate the need for intestinal biopsy. Moreover, this study delves deeper into the “coeliac iceberg” in an attempt to identify people with disorders who may benefit from a gluten-free diet, even in the absence of gastrointestinal symptoms, abnormal serology and histology. This was achieved by looking for TGA-IgA mucosal deposits in duodenal biopsy. This large European multidisciplinary health project paves the way to an improved quality of life for patients by reducing the costs for diagnosis due to delayed findings of CD and to offer business opportunities in terms of diagnostic tools and support.
Keywords: coeliac disease; anti-transglutaminase; mucosal deposits; point-of-care test; negative predictive value; artificial intelligence; intestinal biopsy; ESPGHAN; guidelines coeliac disease; anti-transglutaminase; mucosal deposits; point-of-care test; negative predictive value; artificial intelligence; intestinal biopsy; ESPGHAN; guidelines

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MDPI and ACS Style

Magazzù, G.; Aquilina, S.; Barbara, C.; Bondin, R.; Brusca, I.; Bugeja, J.; Camilleri, M.; Cascio, D.; Costa, S.; Cuzzupè, C.; et al. Recognizing the Emergent and Submerged Iceberg of the Celiac Disease: ITAMA Project—Global Strategy Protocol. Pediatr. Rep. 2022, 14, 293-311. https://doi.org/10.3390/pediatric14020037

AMA Style

Magazzù G, Aquilina S, Barbara C, Bondin R, Brusca I, Bugeja J, Camilleri M, Cascio D, Costa S, Cuzzupè C, et al. Recognizing the Emergent and Submerged Iceberg of the Celiac Disease: ITAMA Project—Global Strategy Protocol. Pediatric Reports. 2022; 14(2):293-311. https://doi.org/10.3390/pediatric14020037

Chicago/Turabian Style

Magazzù, Giuseppe, Samuel Aquilina, Christopher Barbara, Ramon Bondin, Ignazio Brusca, Jacqueline Bugeja, Mark Camilleri, Donato Cascio, Stefano Costa, Chiara Cuzzupè, and et al. 2022. "Recognizing the Emergent and Submerged Iceberg of the Celiac Disease: ITAMA Project—Global Strategy Protocol" Pediatric Reports 14, no. 2: 293-311. https://doi.org/10.3390/pediatric14020037

APA Style

Magazzù, G., Aquilina, S., Barbara, C., Bondin, R., Brusca, I., Bugeja, J., Camilleri, M., Cascio, D., Costa, S., Cuzzupè, C., Duca, A., Fregapane, M., Gentile, V., Giuliano, A., Grifò, A., Grima, A.-M., Ieni, A., Li Calzi, G., Maisano, F., ... Raso, G. (2022). Recognizing the Emergent and Submerged Iceberg of the Celiac Disease: ITAMA Project—Global Strategy Protocol. Pediatric Reports, 14(2), 293-311. https://doi.org/10.3390/pediatric14020037

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