Scottish Paediatric Society St Andrew's Day Paediatric Symposium Friday 12th November 2021.

Background: Children with Down syndrome (DS) are at increased risk of coeliac disease (CD). Current screening practice in DS includes tissue transglutaminase IgA (TGA-IgA) serology. There is no standard UK guidance on the frequency of serology testing or inclusion of HLA-typing for CD predisposing antigens, DQ2 and DQ8. HLA testing can be performed before gluten exposure and to coincide with other routine investigations. A negative DQ2/DQ8 type means patients do not require further coeliac screening. A positive DQ2/DQ8 type allows risk strati fi cation of patients. We explored the cost-effectiveness and family acceptance of a screening strategy that involved both serology and HLA-typing of children with DS. Methods