Antibodies Against Deamidated Gliadin Peptides and Tissue Transglutaminase for Diagnosis of Pediatric Celiac Disease

Olén, Ola; Gudjonsdottir, Audur H.; Browaldh, Lars; Hessami, Mozaffar; Elvin, Kerstin; Liedberg, Ann-Sofie; Neovius, Martin; Grahnquist, Lena

doi:10.1097/mpg.0b013e3182645c54

Cited by 39 publications

(56 citation statements)

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“…However, a recent study [12 & ] showed that there were two subgroups of patients with IgAD (switched memory B cells percentage: 0. 34 ] also determined major lymphocyte subpopulations and B-lymphocyte subsets in patients with IgAD and confirmed the reduction in terminally differentiated B-lymphocyte subsets, similar to what has previously been found in patients with CVID, although less pronounced than in the latter.…”

Section: Updatesupporting

confidence: 79%

IgA deficiency

Wang

Hammarström

2012

Current Opinion in Allergy &Amp; Clinical Immunology

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Section: Updatesupporting

confidence: 79%

IgA deficiency

Wang

Hammarström

2012

Current Opinion in Allergy &Amp; Clinical Immunology

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“…In fact, our findings are in accord with a recent Swedish study evaluating the use of tTG-IgA in clinical practice, which found that among 26 180 children screened for CD primarily by general practitioners or pediatricians (and presumably because of symptoms or conditions suggestive of CD), only 1.3% were diagnosed with CD. 23 A systematic overview of diagnostic testing for CD among adult patients with abdominal symptoms within primary care also revealed that gastrointestinal symptoms alone were not sufficiently accurate for predicting CD. 24 Case-finding by asking for CD-associated conditions also revealed poordiagnostic performance in this population, and the prevalence of undiagnosed CD among children with these conditions was lower than the CD prevalence usually described for these groups.…”

Section: Figurementioning

confidence: 99%

Usefulness of Symptoms to Screen for Celiac Disease

et al. 2014

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WHAT'S KNOWN ON THIS SUBJECT: Celiac disease (CD) often goes undiagnosed. Current guidelines suggest intensified active casefinding, with liberal testing of children with CD-associated symptoms and/or conditions. However, methods for also finding undiagnosed CD cases in the general population should be explored and evaluated.WHAT THIS STUDY ADDS: In a population-based CD screening, information on CD-associated symptoms and conditions, obtained before knowledge of CD status, was not useful in discriminating undiagnosed CD cases from non-CD children. The majority of screening-detected CD cases had no CD-associated symptoms or conditions. abstract OBJECTIVE: To describe the frequency of symptoms and associated conditions among screening-detected celiac disease (CD) cases and non-CD children and to evaluate questionnaire-based case-finding targeting the general population. METHODS:In a population-based CD screening of 12-year-olds, children and their parents completed questionnaires on CD-associated symptoms and conditions before knowledge of CD status. Questionnaire data for those who had their CD detected in the screening (n = 153) were compared with those of children with normal levels of CD markers (n = 7016). Hypothetical case-finding strategies were also evaluated. Questionnaires were returned by 7054 (98%) of the children and by 6294 (88%) of their parents.RESULTS: Symptoms were as common among screening-detected CD cases as among non-CD children. The frequency of children with screening-detected CD was similar when comparing the groups with and without any CD-related symptoms (2.1% vs 2.1%; P = .930) or CD-associated conditions (3.6% vs 2.1%; P = .07). Case-finding by asking for CD-associated symptoms and/or conditions would have identified 52 cases (38% of all cases) at a cost of analyzing blood samples for 2282 children (37%) in the study population. CONCLUSIONS:The current recommended guidelines for finding undiagnosed CD cases, so-called active case-finding, fail to identify the majority of previously undiagnosed cases if applied in the general population of Swedish 12-year-olds. Our results warrant further studies on the effectiveness of CD case-finding in the pediatric population, both at the clinical and population-based levels.

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“…IgG t-TGA can be used in cases of IgA-deficiency (Husby 2012). Antibodies towards tissue tranglutaminase have higher sensitivity in comparison to those towards endomysium (Giersiepen 2012, Olén 2012. Table 1.…”

Section: Diagnosis Serologymentioning

confidence: 99%

“…less than two years of age, antibodies against DGP appear before antibodies to tissue transglutaminase (t-TGA) and can be considered a useful test when the other tests are negative (Husby 2012). In cases of patients with IgA-deficiency, IgG antibodies to DGP can be tested as a complement to antibodies to t-TGA (Olén 2012). The sensitivity and specificity of IgA and IgG towards DGP varies (Giersiepen 2012) (Table 1).…”

Section: Diagnosis Serologymentioning

confidence: 99%

Demographics, clinical features and treatment of pediatric celiac disease

Tapsas¹

2015

Linköping University Medical Dissertations

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Celiac disease (CD) is a chronic small intestinal immune-mediated enteropathy triggered by ingestion of gluten-containing food in genetically predisposed subjects. The enteropathy is presented with a wide variety of clinical manifestations, which can occur even outside the gastrointestinal tract. In the majority of cases, the diagnosis of CD is based on a small intestinal biopsy showing mucosal alterations, i.e. intraepithelial lymphocytosis, crypt hyperplasia, and villous atrophy. The treatment, gluten-free diet (GFD), has recently been revised with the addition of gluten-free oats. Oats give a more diversified nutrition and increase the fibre content. The use of oats in CD is though still debated in some reports. A strict life-long adherence to the GFD can be problematic, especially for pediatric CD patients. Sweden reported of one of the highest observed CD prevalences worldwide, i.e. 3%, among 12-year-olds born during what has been described as "the Swedish celiac epidemic", 1984−1996.The aims of this thesis were to elucidate how pediatric CD has changed during a 41-year period in Sweden, i.e. 1973Sweden, i.e. −2013, in terms of clinical presentation, disease severity, incidence, and demographics. We also wanted to adress the compliance to the GFD, the use of oats in the GFD and the safety of oats inclusion in the diet by measuring urinary nitric oxide (NO) metabolites.Filed information provided data about 2856 pediatric patients investigated for suspected CD between 1973 and 2013; of which 1030 patients were diagnosed with CD. After the data analyses the mean age of CD patients was shown to increase after the celiac epidemic period.Currently, CD shows a less severe picture in terms of symptoms and intestinal pathology.Younger children suffer primarily from gastrointestinal symptoms and growth failure, whereas extra-intestinal manifestations are more often displayed among adolescents. viWe also reported an unusually high pediatric CD incidence rate and cumulative incidence, likely the highest reported worldwide. We hypothesised that the introduction of new antibody tests would affect the diagnostic activity and accuracy in performing small intestinal biopsies for CD investigation. However, the outcome of diagnostic activity and accuracy could not clearly be attributed to the use of antibody tests due to changes occurring in parallel during the 41-year study period, e.g. a different pattern of symptoms at presentation and improved knowledge of the disease among parents and health professionals.In a questionnaire-based study our patient group reported a high compliance to the GFD.Long duration of the GFD may, however, influence compliance negatively. Oats have been included to the GFD of our study population in most of the cases without reporting major complications related to their well-being.The urinary measurements of NO metabolites revealed two patient groups, one with high and one with low levels. The two populations did not differ regarding sex, age, compliance to the GFD or oats consumption. Fa...

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Antibodies Against Deamidated Gliadin Peptides and Tissue Transglutaminase for Diagnosis of Pediatric Celiac Disease

Abstract: For diagnosing CD, tTG is superior to DGP, even in children younger than 2 years. Combining tTG and DGP does not provide a better tradeoff between number of missed cases of CD, number of unnecessary duodenal biopsies, and cost than tTG alone.

Cited by 39 publications

References 17 publications

IgA deficiency

IgA deficiency

Usefulness of Symptoms to Screen for Celiac Disease

Demographics, clinical features and treatment of pediatric celiac disease

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