IgA Deficiency Is Not Systematically Ruled Out in Patients Undergoing Celiac Disease Testing

Nazario, Ezequiel; Lasa, Juan S.; Schill, Amalia; Duarte, Belen; Berardi, Diego; Paz, Silvina; Muryan, Alexis; Zubiaurre, Ignacio

doi:10.1007/s10620-021-06939-x

Cited by 7 publications

(7 citation statements)

References 24 publications

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“…Finally, it is worth reporting that the total IgA measurement is clearly confirmed in only half of the studies (7 out of 14), whereas in the remaining ones, such an important aspect is not specified. Indeed, as emphasized by several authors and guidelines, the concomitant measurement of total serum IgA is an essential step for a complete CD serological screening, since IgA deficiency impairs the reliability of the most sensitive markers, namely EmA and tTG IgA [11,33,34]. In this regard, JIA patients could also be characterized by an increased prevalence of IgA deficiency, as it occurs in several autoimmune disorders [33,35].…”

Section: Juvenile Idiopathic Arthritis and Celiac Diseasementioning

confidence: 99%

Celiac Disease in Juvenile Idiopathic Arthritis and Other Pediatric Rheumatic Disorders

Poddighe

Romano

Dossybayeva

et al. 2022

JCM

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Celiac Disease (CD) is an immune-mediated and gluten-related disorder whose prevalence is higher in children affected with other autoimmune disorders, including diabetes mellitus type 1, autoimmune thyroiditis, and others. As regards Juvenile Idiopathic Arthritis (JIA) and other pediatric rheumatic disorders, there is no clear recommendation for CD serological screening. In this review, we analyze all the available clinical studies investigating CD among children with JIA (and other rheumatic diseases), in order to provide objective data to better understand the necessity of CD serological screening during the follow-up. Based on the present literature review and analysis, >2.5% patients with JIA were diagnosed with CD; however, the CD prevalence in JIA patients may be even higher (>3–3.5%) due to several study limitations that could have underestimated CD diagnosis to a variable extent. Therefore, serological screening for CD in children affected with JIA could be recommended due to the increased CD prevalence in these patients (compared to the general pediatric population), and because these JIA patients diagnosed with CD were mostly asymptomatic. However, further research is needed to establish a cost-effective approach in terms of CD screening frequency and modalities during the follow-up for JIA patients. Conversely, at the moment, there is no evidence supporting a periodical CD screening in children affected with other rheumatic diseases (including pediatric systemic lupus erythematosus, juvenile dermatomyositis, and systemic sclerosis).

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Section: Juvenile Idiopathic Arthritis and Celiac Diseasementioning

confidence: 99%

Celiac Disease in Juvenile Idiopathic Arthritis and Other Pediatric Rheumatic Disorders

Poddighe

Romano

Dossybayeva

et al. 2022

JCM

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“…Moreover, it concomitantly allows to identify those patients who are affected with IgA deficiency (indicated by the lack of a fluorescent signal from the well-coated with anti-human IgA microbeads), which is known to impair the reliability of any CD screening test based on IgA autoantibody. Indeed, it is a mandatory and good clinical practice to request the concomitant (and separate) assessment of total IgA in serum, whenever a patient is screened for CD with anti-tTG IgA by a conventional single-parameter ELISA ( 19 , 20 ). Finally, in addition to this qualitative assessment of total IgA levels, as explained, CytoBead CeliAK assay provides information on other CD-related antibodies (EMA and anti-DG IgA), which usually would require separate analyses and additional workload, if done by using different single-parameter tests.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Reliability of the Multiplex CytoBead CeliAK Immunoassay to Assess Anti-tTG IgA for Celiac Disease Screening

et al. 2021

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Background and Objective: The diagnosis of Celiac Disease (CD) is first based on the positivity for specific serological markers. The CytoBead CeliAK immunoassay simultaneously measures antibodies (IgA) directed to tissue transglutaminase (tTG), endomysium (EMA), and deamidated gliadin (DG), in addition to providing a control for total IgA levels. The aim of this study is to assess the reliability of this multiplex assay to detect anti-tTG IgA positive patients, compared with a conventional single-parameter enzyme-linked immunosorbent assay (ELISA).Methods: Serum samples from 149 pediatric patients were assessed by both CytoBead CeliAK immunoassay and ELISA, in order to evaluate their concordance for the measurement of anti-tTG IgA.Results: The measurement of anti-tTG IgA by CytoBead CeliAK immunoassay basically showed a complete concordance rate with the conventional and single-parameter ELISA, according to the respective cutoff values (3 U/ml and 10 U/ml).Conclusions: Our comparative analysis demonstrates a substantial equivalency between multiplex CytoBead CeliAK assay and the single-parameter conventional ELISA to assess anti-tTG IgA antibody in the context of the screening for CD in children. Importantly, CytoBead CeliAK assay could present some preanalytic, analytic, and economic advantages.

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“…López et al also showed that high IgG antibody serum levels persisted in half of the patients evaluated, even after two years of GFD that, along with the great variability in IgG antibodies utilized for diagnosis, can lead to confusion and difficulty in follow-up. At the same time, another study demonstrated that IgA deficiency is not routinely excluded by means of total serum IgA determination in more than 20% of adult patients who are screened for CD using IgA anti-tTG antibodies, suggesting that the current diagnostic criteria for CD have not yet been fully received and incorporated into clinical practice [53].…”

Section: Influence Of the 2012 Espghan Criteria In Diagnosing And Mon...mentioning

confidence: 99%

Diagnosing and Monitoring Celiac Patients with Selective IgA Deficiency: Still an Open Issue

et al. 2021

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Although, the association between celiac disease (CD) and selective immunoglobulin A deficiency (SIgAD) has been known for more than fifty years, the procedures for diagnosing and monitoring patients with both conditions are still far from definitive. When serological markers were introduced as pre-bioptic investigations, it was immediately clear that searching for specific IgA antibodies without checking total serum IgA could lead to a failure in diagnosing IgA-deficient CD patients, while specific IgG antibodies could be useful as additional tests, because they are frequently found in the serum of affected patients. Nonetheless, until recently the diagnosis of CD in IgA-deficient patients was based on the few, fragmentary and often contradictory data available in literature. The introduction of the European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) guidelines in 2012 provided the current criteria for diagnosing CD in IgA-deficient patients, although some issues remained open, such as the selection of patients who should undergo specific IgG antibody testing and the choice of the most reliable IgG-based test for both diagnosis and follow-up. A real-life study recently assessed the impact of the 2012 ESPGHAN guidelines in diagnosing and monitoring CD in SIgAD patients, highlighting several pitfalls that can lead to operational uncertainties and difficulties in patient management. In the present report, the evolution of diagnostic tools and criteria for CD in SIgAD patients has been critically assessed, both strengths and open issues have been highlighted, and future perspectives for improving the current diagnostic protocols have been suggested.

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IgA Deficiency Is Not Systematically Ruled Out in Patients Undergoing Celiac Disease Testing

Cited by 7 publications

References 24 publications

Celiac Disease in Juvenile Idiopathic Arthritis and Other Pediatric Rheumatic Disorders

Celiac Disease in Juvenile Idiopathic Arthritis and Other Pediatric Rheumatic Disorders

Reliability of the Multiplex CytoBead CeliAK Immunoassay to Assess Anti-tTG IgA for Celiac Disease Screening

Diagnosing and Monitoring Celiac Patients with Selective IgA Deficiency: Still an Open Issue

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