Celiac Disease Diagnosis Without Biopsy

Previtali, Giulia; Licini, Lisa; D’Antiga, Lorenzo; Marseglia, Antonio; Ravasio, Rudi; Nembrini, F; Greco, Salvatore; Sonzogni, Aurelio; Azzarà, Giovanna; Ravelli, P.; Alessio, Maria Grazia

doi:10.1097/mpg.0000000000001773

Cited by 15 publications

(5 citation statements)

References 27 publications

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“…Longer time and lower rate of atTG normalization in CLIA group seem to support the previously published hypothesis of a higher sensitivity and dynamic range of this assay, which could distinguish between positive and negative results (9). This concept has an important clinical implication, since the commercial availability of 2 different tests could bring some confusion in atTG monitoring.…”

Section: Discussionsupporting

confidence: 83%

“…According to the literature (13), a cut off of 2.5 U/mL was used to discriminate between positive and negative samples. From June 2012, atTG IgA was performed using a CLIA method (QUANTA Flash h‐tTG IgA, San Diego, CA) on the platform BIOFLASH, using a cut‐off of 20 chemiluminescent units (9).…”

Section: Methodsmentioning

confidence: 99%

“…In recent years, there are some articles putting CLIA assay forward as a more precise technique for diagnosis of CD with limited data regarding the monitoring children on GFD (9–12). The aim of the present study is to compare the analytical and clinical performance of CLIA and ELISA in monitoring atTG IgA levels in patients diagnosed with CD and started on GFD.…”

mentioning

confidence: 99%

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Trend of Antitissue Transglutaminase Antibody Normalization in Children With Celiac Disease Started on Gluten‐free Diet

Sansotta¹,

Alessio

Norsa³

et al. 2020

J. pediatr. gastroenterol. nutr.

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Background: The aim of this study is to compare the performance of antitissue transglutaminase (atTG) chemiluminescence immunoassay (CLIA) with the standard enzyme-linked immunosorbent assay (ELISA) methods in monitoring celiac children after the start of gluten-free diet (GFD). Methods: Celiac children diagnosed between 2005 and 2016 at our centre were classified into 2 groups based on serum assay (ELISA vs CLIA) used for atTG monitoring, and were compared on percentage of decrease and time to normalization of atTG on GFD. Results: Among 260 included children, the rate of normalization of atTG levels at 30 months’ follow-up was 86% and 70% in ELISA and CLIA group, respectively (P < 0.01). Median time to normalization was 11.7 and 14.7 months in ELISA and CLIA group respectively (P = 0.003). Marsh score at diagnosis was not associated with time to atTG normalization (P = 0.770), whereas older age at diagnosis and higher baseline atTG predicted longer time to atTG normalization (P = 0.01, P < 0.01). Conclusions: The percentage and the time of the atTG normalization in celiac children on GFD should be interpreted according to the utilized assay: at 30 months’ follow-up children tested by CLIA are less likely to normalize atTG levels compared to those tested by ELISA. Younger age at diagnosis and lower baseline atTG are predictors of earlier atTG normalization, regardless of the adopted assay.

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Section: Discussionsupporting

confidence: 83%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Trend of Antitissue Transglutaminase Antibody Normalization in Children With Celiac Disease Started on Gluten‐free Diet

Sansotta¹,

Alessio

Norsa³

et al. 2020

J. pediatr. gastroenterol. nutr.

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“…Studies have evaluated whether this strategy can be applied in symptomatic adult CD. [10][11][12][13][14][15][16][17][18][19][20][21] These studies have suggested that tTG levels of ≥10×ULN could be predictive of CD in adults, and the recently published Finnish national guidelines for the diagnosis of CD have incorporated this diagnostic pathway into their practice. 22 However, this approach has not been widely adopted into adult clinical practice or guidelines.…”

Section: Coeliac Diseasementioning

confidence: 99%

Accuracy of a no-biopsy approach for the diagnosis of coeliac disease across different adult cohorts

Penny

Raju

Lau

et al. 2020

Gut

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ObjectiveWe aimed to determine the predictive capacity and diagnostic yield of a 10-fold increase in serum IgA antitissue transglutaminase (tTG) antibody levels for detecting small intestinal injury diagnostic of coeliac disease (CD) in adult patients.DesignThe study comprised three adult cohorts. Cohort 1: 740 patients assessed in the specialist CD clinic at a UK centre; cohort 2: 532 patients with low suspicion for CD referred for upper GI endoscopy at a UK centre; cohort 3: 145 patients with raised tTG titres from multiple international sites. Marsh 3 histology was used as a reference standard against which we determined the performance characteristics of an IgA tTG titre of ≥10×ULN for a diagnosis of CD.ResultsCohort 1: the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for IgA tTG levels of ≥10×ULN at identifying individuals with Marsh 3 lesions were 54.0%, 90.0%, 98.7% and 12.5%, respectively. Cohort 2: the sensitivity, specificity, PPV and NPV for IgA tTG levels of ≥10×ULN at identifying individuals with Marsh 3 lesions were 50.0%, 100.0%, 100.0% and 98.3%, respectively. Cohort 3: the sensitivity, specificity, PPV and NPV for IgA tTG levels of ≥10×ULN at identifying individuals with Marsh 3 lesions were 30.0%, 83.0%, 95.2% and 9.5%, respectively.ConclusionOur results show that IgA tTG titres of ≥10×ULN have a strong predictive value at identifying adults with intestinal changes diagnostic of CD. This study supports the use of a no-biopsy approach for the diagnosis of adult CD.

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“…Niños con TGA-IgA positivo, pero títulos más bajos (<10 veces el límite superior de lo normal), deben someterse a biopsias para disminuir el riesgo de diagnóstico falso positivo. [13][14][15] Las pruebas de HLA aún con presencia de síntomas no es criterio diagnóstico único, sin una serología positiva y diagnóstico basado en biopsia intestinal. 16,17 Hay personas que tienen más riesgo de desarrollar la enfermedad, sobre todo las que tienen familiares de primer grado afectos o las que padecen otras enfermedades en las que interviene el sistema inmune como la diabetes, enfermedad inflamatoria intestinal.…”

Section: -12unclassified

Características Clínicas y Demográficas de la Enfermedad Celíaca en Panamá

Águila

2021

Pediatr Panama

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Introducción: La enfermedad celíaca es un proceso sistémico de carácter inmunológico, desencadenado por el consumo de gluten, que se da en sujetos genéticamente predispuestos. Es una condición prevalente a nivel mundial con síntomas comunes con otras patologías gastrointestinales y no gastrointestinales. En Panamá es una entidad conocida pero poco estudiada. Materiales y Método: El diseño del estudio fue observacional, descriptivo y de carácter retrospectivo en población pediátrica y adulta de la República de Panamá en unidades de gastroenterología públicas y privadas que proporcionaron sus archivos clínicos recolectados en un documento elaborado para uniformidad de las variables. Resultados: Se analizó la información de 171 expedientes. Se dividió la información en pacientes pediátricos y pacientes adultos encontrando 68 casos menores de 15 años y 103 casos mayores de 15 años. La proporción de casos masculinos y femenino fue de 1:1. De la totalidad de casos estudiados, la mayoría eran de la ciudad de Panamá en un 77% y de los extranjeros diagnosticados la población israelí fue la más frecuentemente encontrada en un 76%. Los síntomas gastrointestinales más frecuentemente encontrados fueron la distensión abdominal, diarrea crónica y pérdida de peso respectivamente. La dermatitis herpetiforme, patología tiroidea y las aftas orales fueron las condiciones no gastroenterológicas más frecuentemente encontradas. La Diabetes mellitus tipo I fue la patología encontrada que coexistió con enfermedad celíaca. Conclusión: Con este estudio de carácter epidemiológico, se ha demostrado que la enfermedad celíaca es prevalente en nuestro medio sin poder mostrar un porcentaje específico.

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Celiac Disease Diagnosis Without Biopsy

Cited by 15 publications

References 27 publications

Trend of Antitissue Transglutaminase Antibody Normalization in Children With Celiac Disease Started on Gluten‐free Diet

Trend of Antitissue Transglutaminase Antibody Normalization in Children With Celiac Disease Started on Gluten‐free Diet

Accuracy of a no-biopsy approach for the diagnosis of coeliac disease across different adult cohorts

Características Clínicas y Demográficas de la Enfermedad Celíaca en Panamá

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