Speeding up coeliac disease diagnosis in the developing countries

Crovella, Sérgio; Brandão, Letícia Resende; Guimarães, Romeu Cardoso; Filho, José Luiz de Lima; Arraes, Luciana Cardoso Martins; Ventura, Alessandro; Not, Tarcisio

doi:10.1016/j.dld.2007.04.016

Cited by 27 publications

(24 citation statements)

References 9 publications

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“…In a cost-effectiveness analysis in our geographic area, south of Brazil, the cost of IgA EmA or anti-tTG is 8 times the cost of the studied test, another reason to use this screening. The same conclusions were reported by Crovella et al [42] in another Brazilian area (Recife, Northeast).…”

Section: Discussionsupporting

confidence: 78%

“…In 9 patients of this investigation, who were point-of-care test negative, the final diagnosis confirmed that the patients were not celiac patients [3,41,42] . In a cost-effectiveness analysis in our geographic area, south of Brazil, the cost of IgA EmA or anti-tTG is 8 times the cost of the studied test, another reason to use this screening.…”

Section: Discussionmentioning

confidence: 66%

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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: 78%

Section: Discussionmentioning

confidence: 66%

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

Kotze¹,

Rodrigues²,

Kotze³

et al. 2009

WJG

View full text Add to dashboard Cite

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“…The prevalence of CD observed in this group of females with TS (3.6%) was lower than the prevalence of 6.4% reported by Bonamico et al (4) but similar to the prevalence found in other studies, varying from 2.2 to 5.0% (8,12,13) . Some of those studies have shown that part of the diagnosed patients were asymptomatic or presented atypical forms of CD.…”

Section: Discussioncontrasting

confidence: 52%

Screening for celiac disease among patients with Turner syndrome in Brasília, DF, midwest region of Brazil

Dias

Castro

Gandolfi

et al. 2010

Arq. Gastroenterol.

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-Context -Several studies have demonstrated a higher prevalence of celiac disease (CD) among females with Turner syndrome when compared to the general population. Nevertheless, there is no record in literature concerning this investigation among Brazilian patients. Objective -To assess the prevalence of CD among a group of Brazilian patients with Turner syndrome. Methods -Fifty-six females with Turner syndrome and on gluten-containing diet were screened for CD utilizing immunoglobulin A antiendomysium (IgA-EMA) and immunoglobulin A anti-tissue transglutaminase (IgA-tTG) antibody assays. Additionally, they were genotyped for CD human leukocyte antigen (CD-HLA) predisposing alleles. Patients showing positivity in serological testing were offered to perform small intestine biopsy for histological confirmation. Results -Mean age at diagnosis of Turner syndrome was 5.5 ± 4.4 years; mean age at screening for CD was 17.0 ± 9.3 years (from 10 months of age to 52 years). Two girls were positive for IgA-EMA and IgA-tTG, presented predisposing HLA-DQ2 alleles and both had the diagnosis of CD confirmed by jejunal biopsy. Conclusion -The 3.6% prevalence of biopsy-proven CD among this group of females with Turner syndrome is 10 times higher than the one among females from the general population of the same geographical area. This result provides additional support to an association between these two disorders and restates that girls and women with Turner syndrome represent a high risk population for developing CD.

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“…Therefore, serological tests accompanied by and duodenal biopsy are still mandatory to confirm the diagnosis of CD. Some Brazilian studies (3,7,10,11,24,26,27,28,37) showed high CD prevalence through the evaluation of the level of antitransglutaminase and duodenal biopsy, including 1:214 in São Paulo (26) , 1:273 in Riberão Preto (24) , 1:417 in Curitiba (27) and 1:681 in Brasilia (10) .…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Genetic Susceptibility for Celiac Disease in Blood Donors in São Paulo, Brazil

Muniz

Sdepanian

Neto

2016

Arq. Gastroenterol.

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-Background -Celiac disease is a permanent intolerance induced by gluten, which is expressed by T-cell mediated enteropathy, and has a high prevalence in the general population. There is evidence of a strong genetic predisposition to celiac disease. Objective -To determine the prevalence of genetic markers HLA-DQ2 and HLA-DQ8 in blood donors from São Paulo and measure human recombinant tissue transglutaminase antibody IgA class in HLA-DQ2 and HLA-DQ8 positive donors.Methods -A total of 404 blood donors from São Paulo city and Jundiaí were included in the study and signed the informed consent form. Information regarding diarrhea, constipation and abdominal pain in the last 3 months was collected. Determination of HLADQ2 and HLADQ8 alleles was performed in all participants and human recombinant tissue transglutaminase antibody class IgA was measured only in blood donors who presentedDQ2 and/or DQ8. Results -HLADQ2 and/or HLADQ8 were positive in 49% (198/404) of subjects. Positive samples were associated with alleles DR3, DR4, DR7, DR11 and DR12. The most frequent genotype was DR4-DQ8, which was present in 13.6% of samples, followed by genotypes DR3-DQ2 and DR7-DQ2 with DQB1*02 in heterozygous, which were present in 10.4% and 8.7%, respectively. Eleven out of 198 positive donors (5%) were positive to human tissue transglutaminase test. Conclusion -We observed a high prevalence of genetic markers for celiac disease, HLA-DQ2 and HLA-DQ8, in blood donors from São Paulo, similar to prevalence described in Europe. These findings show that the prevalence of celiac disease should not be rare in our country, but underdiagnosed.

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Speeding up coeliac disease diagnosis in the developing countries

Cited by 27 publications

References 9 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

Screening for celiac disease among patients with Turner syndrome in Brasília, DF, midwest region of Brazil

Prevalence of Genetic Susceptibility for Celiac Disease in Blood Donors in São Paulo, Brazil

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