Understanding the Variation in Use of Screening DXA Scans in Pediatric Patients with Celiac Disease

Jennifer Webster^1, , Kathy Shaw^{1, 2}, Judy Shea², April Taylor¹ and Ritu Verma¹

¹The Children’s Hospital of Philadelphia, United States

²University of Pennsylvania Perelman School of Medicine, United States

Cite this paper:
Jennifer Webster, Kathy Shaw, Judy Shea, April Taylor and Ritu Verma. Understanding the Variation in Use of Screening DXA Scans in Pediatric Patients with Celiac Disease. International Journal of Celiac Disease. 2017; 5(4):155-158. doi: 10.12691/ijcd-5-4-7

Abstract

Celiac disease (CD) is an immune-mediated genetic disorder occurring secondary to gluten exposure and increasing the likelihood of low bone mineral density (BMD). As there are no published guidelines for dual-x-ray absorptiometry (DXA) scanning in pediatric CD patients, we characterized current practices of pediatric gastroenterologists in ordering screening DXA scans for pediatric CD patients. To accomplish this, A REDCap survey was distributed to the NASPGHAN listserv. There was a total of 231 (11%) responses. The majority (60%) of clinicians do not order screening DXA scans because they don’t believe it is clinically necessary. Patient factors influenced ordering screening DXA scans with fracture history driving ordering and tissue transglutaminase (tTG) level not affecting practice. Physician factors such as practice type and experience were not associated with ordering screening DXA scans. Case scenarios, showed wide variation in management based on DXA results.

Keywords:
celiac disease bone survey guidelines pediatric

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