Inter- and Intra-assay Variation in the Diagnostic Performance of Assays for Anti-tissue Transglutaminase in 2 Populations

Singh, Prashant; Singh, Alka; Silvester, Jocelyn A.; Sachdeva, Vikas; Chen, Xinhua; Xu, Hua; Leffler, Daniel A.; Ahuja, Vineet; Kelly, Ciarán P.; Makharia, Govind

doi:10.1016/j.cgh.2019.09.018

Cited by 10 publications

(10 citation statements)

References 8 publications

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“…We have observed a high intra-assay variation, as well as variation between two racially distinct geographical populations in the diagnostic performance of IgA anti-tTG assays for the diagnosis of CeD. 32 The assay with the highest sensitivity in the Indian population had the lowest sensitivity in the Canadian population. This highlights the importance of the assessment of performance of a particular assay in the specific population being tested to avoid both over-and underdiagnosis of CeD.…”

Section: Setting Up Of Facility For Diagnosis Of Cedmentioning

confidence: 87%

“…With a difference in the genetic makeup and the amount of gluten ingestion, these cut‐offs for a positive test, which have been determined for the Caucasian population, may not have similar diagnostic accuracy for Asian patients. We have observed a high intra‐assay variation, as well as variation between two racially distinct geographical populations in the diagnostic performance of IgA anti‐tTG assays for the diagnosis of CeD 32 . The assay with the highest sensitivity in the Indian population had the lowest sensitivity in the Canadian population.…”

Section: Identification Of Challenges and Suggested Strategiesmentioning

confidence: 97%

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Opportunities and challenges in the management of celiac disease in Asia

et al. 2020

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Although once considered uncommon, there is increasing recognition of celiac disease (CeD) in Asia. It is now clear that CeD is a disorder as frequent in certain Asian countries as that in western countries, although it often remains undiagnosed. With increasing awareness and diagnosis, the absolute numbers of celiac patients are expected to increase markedly in Asia. Asia, with 60% of the population of the world, is probably the major "reservoir" of undiagnosed CeD in the world. As Asia has a huge landscape along with highly heterogenous genetic, social, cultural, and nutritional practices, similar heterogeneity is seen in the epidemiology, diagnostic, and therapeutic facilities for CeD in Asia. In this article, we have reviewed the changes in the epidemiology, diagnostics, and management of CeD in Asia and summarized the challenges and opportunities for its emergence in Asia.

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Section: Setting Up Of Facility For Diagnosis Of Cedmentioning

confidence: 87%

Section: Identification Of Challenges and Suggested Strategiesmentioning

confidence: 97%

Opportunities and challenges in the management of celiac disease in Asia

et al. 2020

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“…In another study, we have observed different cutoff values of the anti-tissue transglutaminase Ab test between North American and Indian patients with CeD. 71 The successful management of CeD is primarily dependent on a combination of factors involving the understanding of disease by the patient as well as following the prescribed dietary restrictions. There is a dearth of trained dietitians in Asia to adequately counsel these patients.…”

Section: Discussionmentioning

confidence: 90%

Emergence of Celiac disease and Gluten-related disorders in Asia

Mohta

Rajput

Ahuja

et al. 2021

J Neurogastroenterol Motil

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“…This is due to a significant intra‐test and inter‐test variations in the diagnostic accuracies of commercially available IgA tTG‐ab assays. A recent validation study showed that the false‐negative rate for commercially available IgA tTG‐ab assays could be as high as 24% 64 . A significant proportion of CeD patients may be missed if a single negative IgA anti‐tTG result is relied on to screen patients for CeD.…”

Section: Discussionmentioning

confidence: 99%

“…A recent validation study showed that the false-negative rate for commercially available IgA tTG-ab assays could be as high as 24%. 64 A significant proportion of CeD patients may be missed if a single negative IgA anti-tTG result is relied on to screen patients for CeD. Also, around 2% CeD patients may have seronegative CeD in the presence of normal IgA levels, which can be diagnosed by duodenal biopsies.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of celiac disease in patients with short stature: A systematic review and meta‐analysis

Singh

Farooqui

et al. 2020

J of Gastro and Hepatol

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Background and AimShort stature is a common extraintestinal manifestation of celiac disease (CeD). We conducted a systematic review and meta‐analysis to assess the global prevalence of CeD in patients presenting with short stature.MethodsWe searched Medline and EMBASE databases for the keywords “celiac disease, coeliac disease, anti‐gliadin, tissue transglutaminase antibody, anti‐endomysial antibody, short stature and growth retardation.” All the studies published from January 1991 to May 2020 were included. Patients without any prior evaluation for short stature were classified as all‐cause short stature, while prior evaluated patients, where no cause was found for short stature, were classified as idiopathic short stature. The diagnosis of CeD was based on the European Society for Paediatric Gastroenterology, Hepatology and Nutrition guidelines. A random‐effects model was used to pool the data.ResultsSeventeen studies screening 3759 patients (1582 with all‐cause short stature and 2177 with idiopathic short stature) were included. The pooled seroprevalence of CeD based on positive anti‐tissue transglutaminase antibody and anti‐endomysial antibody was 11.2% (95% CI 4.0–21.2%; I2 = 86%) and 9.7% (95% CI 2.7–20.2%; I2 = 95%) for all‐cause and idiopathic short stature, respectively. Similarly, pooled prevalence of biopsy‐confirmed CeD was 7.4% (95% CI 4.7–10.6%; I2 = 76%) and 11.6% (95% CI 4.1–22.2%; I2 = 97%), for all‐cause and idiopathic short stature, respectively. There was an overall severe risk of selection bias and significant heterogeneity in the pooled results.ConclusionsApproximately one in 14 patients with all‐cause short stature and one in nine patients with idiopathic short stature had biopsy‐confirmed CeD. Therefore, evaluation for CeD may be prudent in all patients with short stature.

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Inter- and Intra-assay Variation in the Diagnostic Performance of Assays for Anti-tissue Transglutaminase in 2 Populations

Cited by 10 publications

References 8 publications

Opportunities and challenges in the management of celiac disease in Asia

Opportunities and challenges in the management of celiac disease in Asia

Emergence of Celiac disease and Gluten-related disorders in Asia

Prevalence of celiac disease in patients with short stature: A systematic review and meta‐analysis

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