Diagnostic accuracy of coeliac serological tests: a prospective study

Reeves, Glenn; Squance, Marline L.; Duggan, Anne; Murugasu, R.; Wilson, Robert J.; Wong, Richard; Gibson, Robert; Steele, Richard; Pollock, Wendy

doi:10.1097/00042737-200605000-00006

Cited by 84 publications

(84 citation statements)

References 29 publications

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“…The proportion of our subjects with histopathologically confirmed celiac disease is comparable to the results of a study by Reeves et al (7), but considerably higher than that reported by Hill et al (19).…”

Section: Discussionsupporting

confidence: 88%

“…Epidemiological data about celiac disease in Serbia are virtually non-existent. The age structure of our subjects was similar to those reported for Australian (7) and British (19) populations, but there were fewer women in our sample.…”

Section: Discussionsupporting

confidence: 85%

“…The pathogenesis of celiac disease involves com plex interactions between immune, genetic and dietary factors, the latter being associated with ingestion of gluten (7). After partial degradation by gastric, pancreatic and intestinal brush-border membrane proteases, gluten polypeptides are transported across the mucosal epithelium.…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic Accuracy of IGA Anti-Tissue Transglutaminase Antibody Testing in Celiac Disease

Eremić¹,

Đerić²,

Hadnađev³

2012

Journal of Medical Biochemistry

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Diagnostic Accuracy of IGA Anti-Tissue Transglutaminase Antibody Testing in Celiac DiseaseContemporary guidelines for the first-line diagnosis of celiac disease recommend determination of IgA anti-tissue transglutaminase antibodies or IgA antiendomysial antibodies, as well as total serum IgA antibodies. The aim of our study was to assess the validity and clinical significance of serological testing for IgA anti-tissue transglutaminase antibodies in the diagnosis of celiac disease, and to investigate the presence of malabsorption symptoms in celiac patients. IgA anti-tissue transglutaminase antibody testing was performed in 50 subjects with clinically suspected celiac disease (21 men and 29 women). All subjects underwent endoscopy with small intestine biopsy. Celiac disease was confirmed by histopathological findings in four subjects, whereas the IgA anti-tissue transglutaminase test was positive in three subjects. The IgA anti-tissue transglutaminase test showed sensitivity of 75% and specificity of 100%. There were significant differences between men with biopsy-confirmed and excluded celiac disease in the erythrocyte parameters MCV (96.5±7.7 vs. 78.6 ±11.3; p<0.05), MCH (36.9±4.6 vs. 25.9±4.9; p<0.01), and MCHC (382.5±16.3 vs. 326.9±19.1; p<0.005), as well as in the levels of total protein (47.5 ±16.3 vs. 68.3 ± 7.6; p<0.01) and albumins (24.6±9.5 vs. 42.1 ± 6.9; p<0.01). In addition, HDL-cholesterol levels were significantly lower in men with biopsy-confirmed celiac disease (0.42.±0.12 vs. 0.90±0.30; p<0.05). Our results show a high correlation between IgA anti-tissue transglutaminase testing and endoscopy with biopsy as the gold diagnostic standard.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 85%

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Diagnostic Accuracy of IGA Anti-Tissue Transglutaminase Antibody Testing in Celiac Disease

Eremić¹,

Đerić²,

Hadnađev³

2012

Journal of Medical Biochemistry

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“…CD is one of the most common gastrointestinal disorders, with a prevalence of 1:100-1:200 in the general population (1)(2)(3). The large increase in CD diagnosis over recent decades is in large part due to the availability of immunoassays with excellent diagnostic accuracy, such as the IgA anti-transglutaminase (anti-tTG) antibody assay (4)(5)(6)(7)(8). However, discordant data between adults and children have been reported as the anti-tTG assay is less accurate in very young patients and autoantibody levels can fluctuate (9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

The old and new tests for celiac disease: which is the best test combination to diagnose celiac disease in pediatric patients?

Brusca

Carroccio²,

Tonutti³

et al. 2012

Clinical Chemistry and Laboratory Medicine

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Background: In the diagnosis of celiac disease (CD), serum assays for anti-endomysium (EMA) and anti-transglutaminase (anti-tTG) antibodies have excellent diagnostic accuracy. However, these assays are less sensitive in young pediatric patients. Recently, a new ELISA test using deamidated gliadin peptides (DGP) as antigen has proved to be very sensitive and specific even in pediatric patients. In addition, anti-actin IgA antibodies (AAA) is another test that can be used in CD patients because antibody concentrations correlate with the degree of villous atrophy. This study evaluated the clinical accuracy of anti-tTG, EMA, AGA, anti-DGP and AAA and the effectiveness of these in different combinations for diagnosing CD in a large cohort of pediatric patients. Methods: Sera of 150 children under 6 years of age were tested: 95 patients had a diagnosis of CD, while 55 patients who did not suffer from CD were used as controls. Anti-DGP IgA/IgG and AAA were assayed with ELISA kits, while anti-tTG IgA/IgG and AGA IgG/IgA were assayed using a quantitative fluoroimmunoassay. The EMA test was conducted by indirect immunofluorescence.

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“…The neoepitope screening assay detects antibodies to tTG, deamidated gliadin peptide and to the neoepitope and is thus the first assay used in our algorithm. This assay was able to provide earlier detection than the other tTG ELISA kits; 12,13 however, such cases may be interpreted as falsepositive cases by the first line screen. Applying the second-step screen with the tTG IgA and tTG IgA1IgG assays eliminated the false-positive results in many cases.…”

Section: Discussionmentioning

confidence: 99%

A new algorithm for the diagnosis of celiac disease

et al. 2011

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Celiac disease (CD) affects at least 1% of the Western population but remains largely unrecognized. In our laboratory, we utilize a novel algorithm to diagnose pediatric CD that offers both high sensitivity and high specificity for diagnosis in an outpatient setting. The aim of the present study was to challenge this algorithm and to test its performance in children and adults suspected of having CD. Using a three-assay algorithm, screening with the most sensitive tissue transglutaminase (tTG) complexed with deamidated gliadin peptide neoepitope immunoglobulin A (IgA)1IgG assay and confirming with the two specific tTG IgA and tTG IgA1IgG assays, we examined the serological results from 112 children aged 0-17 years old and 60 adults in comparison to their respective biopsy results. The algorithm performance was calculated by statistical analysis. The use of the new algorithm enabled us to diagnose CD with 98% sensitivity, 93% specificity and 95% accuracy in the pediatric group and 94% sensitivity, 92% specificity and 93% accuracy in the total population studied. The false-negative cases in the adult group were attributed to previous adherence to a gluten-free diet, and the single false-negative result in a young child became a true positive after 6 months. We have also monitored three celiac patients before and after diagnosis and found that the algorithm may be suitable for disease monitoring. The newly proposed three-assay algorithm for celiac detection is very reliable in both children and adults. Due to the high performance of this assay, the further need for confirmatory intestinal biopsies will be reassessed.

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Diagnostic accuracy of coeliac serological tests: a prospective study

Cited by 84 publications

References 29 publications

Diagnostic Accuracy of IGA Anti-Tissue Transglutaminase Antibody Testing in Celiac Disease

Diagnostic Accuracy of IGA Anti-Tissue Transglutaminase Antibody Testing in Celiac Disease

The old and new tests for celiac disease: which is the best test combination to diagnose celiac disease in pediatric patients?

A new algorithm for the diagnosis of celiac disease

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