Population screening for coeliac disease in primary care by district nurses using a rapid antibody test: diagnostic accuracy and feasibility study

Korponay-Szabó, Ilma Rita; Szabados, Katalin; Pusztai, Jánosné; Uhrin, Katalin; Ludmány, E; Nemes, Éva; Kaukinen, Katri; Kapitány, Anikó; Koskinen, Lotta; Sipka, Sándor; Imre, Anikó; Mäki, Markku

doi:10.1136/bmj.39405.472975.80

Cited by 128 publications

(121 citation statements)

References 32 publications

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“…In this investigation, in the CD-suspicion group, the point-of-care test was positive in 83.3% (5/6) patients, similar to the report of Korponay-Szabó et al [24] . It is possible that a patient can have only one CD-specific test positive, as was the case of the female patient with Biocard test negative and IgA EmA positive, or the male 62-year-old with this test positive, anti-tTG increased (193 U) and IgA EmA negative (Table 2).…”

Section: Discussionsupporting

confidence: 76%

A Brazilian experience of the self transglutaminase-based test for celiac disease case finding and diet monitoring

Kotze¹,

Rodrigues²,

Kotze³

et al. 2009

WJG

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AIM:To evaluate the effectiveness of a rapid and easy fingertip whole blood point-of-care test for celiac disease (CD) case finding and diet monitoring. METHODS:Three hundred individuals, 206 females (68.7%) and 94 males (31.3%), were submitted to a rapid and easy immunoglobulin-A-class fingertip whole blood point-of-care test in the doctor's office in order to make immediate clinical decisions: 13 healthy controls, 6 with CD suspicion, 46 treated celiacs, 84 relatives of the celiac patients, 69 patients with dyspepsia, 64 with irritable bowel syndrome (IBS), 8 with Crohn's disease and 9 with other causes of diarrhea. RESULTS:Upper gastrointestinal endoscopy with duodenal biopsies was performed in patients with CD suspicion and in individuals with positive test outcome: in 83.3% (5/6) of the patients with CD suspicion, in 100% of the patients that admitted gluten-free diet transgressions (6/6), in 3.8% of first-degree relatives (3/79) and in 2.9% of patients with dyspepsia (2/69). In all these individuals duodenal biopsies confirmed CD (Marsh's histological classification). The studied test showed good correlation with serologic antibodies, endoscopic and histological findings. CONCLUSION:The point-of-care test was as reliable as conventional serological tests in detecting CD cases and in CD diet monitoring.

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Section: Discussionsupporting

confidence: 76%

A Brazilian experience of the self transglutaminase-based test for celiac disease case finding and diet monitoring

Kotze¹,

Rodrigues²,

Kotze³

et al. 2009

WJG

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“…In all of those studies the positive predictive value of the test was much higher than the value found here, and the sensitivity results were also close to 100%. However, our study supports previous evidence to demonstrate the real value of this test kit as a CD screening method in asymptomatic subjects (12). The prevalence of CD in our study group of apparently healthy patients suggests that 1 in 33 people have subclinical CD.…”

Section: Analysis Of the Diagnostic Validity Of The Point-of-care Tessupporting

confidence: 79%

“…The high estimated prevalence of subclinical CD in apparently healthy children means that a noninvasive screening method is required. The results of previous studies using a rapid visual immunochromatographic bedsite test (point-of-care testing) have been promising (6)(7)(8)(9)(10)(11)(12)(13).…”

mentioning

confidence: 99%

Diagnostic screening for subclinical celiac disease using a rapid test in children aged 2–4

Almazán¹,

Ortega²,

Torres

et al. 2015

Pediatr Res

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Background: Our aim is to study the prevalence of subclinical celiac disease (CD) and analyze the diagnostic yield of a new rapid test in children aged 2-4. Methods: We carried out a cross-sectional study in a sample population of children aged 2-4 from the same metropolitan area. We recruited apparently healthy subjects, and collected clinical, anthropometric, analytical, and serological variables. We also tested for anti-gliadin IgA and anti-transglutaminase IgG and IgA using a rapid immunochromatographic test CD1WB and CD2WB (Operon, Zaragoza, Spain). results: One hundred and ninety-eight children were recruited, signed the informed consent form, and completed the protocol (mean age 32.3 ± 9.2 mo, 53% males). CD prevalence according to the serological tests was 3% (CI 95%, 1.4-6.4%). Biopsies were used to confirm the diagnosis in all suspected cases. The sensitivity and negative predictive value of the CD2WB immunochromatographic test strip were 100% and 1, respectively. The sensitivity of CD1WB was 16.6% and its specificity was high (89.1%). conclusion: The prevalence of subclinical CD in the sample group of 2-4-y old was higher than that found by other authors. The CD2WB immunochromatographic test strip is an excellent diagnostic screening tool with high sensitivity and negative predictive value.

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“…35 We have also shown these prominent complications to be present in otherwise asymptomatic patients, 23,36 and there is some evidence that the introduction of a gluten-free diet can improve poor growth and hemoglobin values also in screen-detected children. 37 Other possible complications which have been observed regardless of the clinical presentation of celiac disease are for instance low bone mineral density, dental enamel defects and elevated transaminases.…”

Section: Discussionmentioning

confidence: 96%

At-Risk Screened Children with Celiac Disease are Comparable in Disease Severity and Dietary Adherence to Those Found because of Clinical Suspicion: A Large Cohort Study

Kivelä

Kaukinen

Huhtala

et al. 2017

The Journal of Pediatrics

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Population screening for coeliac disease in primary care by district nurses using a rapid antibody test: diagnostic accuracy and feasibility study

Cited by 128 publications

References 32 publications

A Brazilian experience of the self transglutaminase-based test for celiac disease case finding and diet monitoring

A Brazilian experience of the self transglutaminase-based test for celiac disease case finding and diet monitoring

Diagnostic screening for subclinical celiac disease using a rapid test in children aged 2–4

At-Risk Screened Children with Celiac Disease are Comparable in Disease Severity and Dietary Adherence to Those Found because of Clinical Suspicion: A Large Cohort Study

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