Document Detail


Celiac disease: the new proposed ESPGHAN diagnostic criteria do work well in a selected population.
MedLine Citation:
PMID:  23111763     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The need for an early and accurate diagnosis in celiac disease (CD) has focused attention on new diagnostic approaches, based on the efficiency of serological markers and the high negative predictive value of human leukocyte antigen (HLA) non-DQ2/8.
METHODS: We performed a retrospective review of all of the patients suspected of having CD who had undergone a small bowel biopsy in our gastroenterology unit. All symptomatic children with serological marker at time of biopsy (immunoglobulin A-tissue transglutaminase antibody, endomysial antibody, and HLA genotype) were included. The triple test (TT) was positive if immunoglobulin A-tissue transglutaminase antibody was 10 times the upper limit of normal, plus positive endomysial antibody plus human leukocyte antigen-DQ2/DQ8.
RESULTS: A total of 150 patients met the inclusion criteria and were enrolled in the study. One hundred sixteen were positive for the TT; 113 of 116 (97.4%) had a Marsh 2/3 histological lesion and had been considered to have CD. Thus, positive predictive value of the TT was 97.4%. The other 3 cases (2.6%) had Marsh 0/1 lesion, so we consider them to be false-positives for the TT; however, on follow-up, all 3 children developed histological damage after a gluten challenge. Finally, the positive predictive value of the TT was 100%. Thirty-four patients were negative for the TT: 22 patients are celiac, 3 are celiac but challenge gluten diet is pending, and the 9 patients left have other gastrointestinal disorder.
CONCLUSIONS: Our study supports the view that in selected children who are symptomatic and positive for the TT, CD diagnosis could be established independent of histological findings.
Authors:
Gabriela Klapp; Etna Masip; Miguel Bolonio; Ester Donat; Begoña Polo; David Ramos; Carmen Ribes-Koninckx
Related Documents :
89333 - Antithyroid-antibody activity in the snyovial fluid of patients with various arthritides.
7918043 - The 'euthyroid sick syndrome': incidence, risk factors and prognostic value soon after ...
6119763 - Clinical effect of metronidazole and sulfasalazine on crohn's disease in relation to ch...
Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Journal of pediatric gastroenterology and nutrition     Volume:  56     ISSN:  1536-4801     ISO Abbreviation:  J. Pediatr. Gastroenterol. Nutr.     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-02-26     Completed Date:  2013-08-27     Revised Date:  2013-11-08    
Medline Journal Info:
Nlm Unique ID:  8211545     Medline TA:  J Pediatr Gastroenterol Nutr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  251-6     Citation Subset:  IM    
Affiliation:
Pediatric Gastroenterology and Hepatology, La Fe University Hospital, Valencia, Spain.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adolescent
Autoantibodies / analysis*
Biological Markers / blood
Celiac Disease / blood,  diagnosis*,  immunology,  pathology
Child
Child, Preschool
Europe
Female
Follow-Up Studies
GTP-Binding Proteins / antagonists & inhibitors*
HLA Antigens / analysis,  genetics*
Haplotypes
Humans
Immunoglobulin A / analysis
Infant
Intestinal Mucosa / pathology
Male
Muscle Fibers, Skeletal / immunology*
Practice Guidelines as Topic*
Predictive Value of Tests
Retrospective Studies
Societies, Scientific
Transglutaminases / antagonists & inhibitors*
Chemical
Reg. No./Substance:
0/Autoantibodies; 0/Biological Markers; 0/HLA Antigens; 0/Immunoglobulin A; EC 2.3.2.-/transglutaminase 2; EC 2.3.2.13/Transglutaminases; EC 3.6.1.-/GTP-Binding Proteins
Comments/Corrections
Comment In:
J Pediatr Gastroenterol Nutr. 2013 Mar;56(3):241   [PMID:  23085890 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Disparities in prevalence of key chronic diseases by gender and race/ethnicity among antiretroviral-...
Next Document:  Gastroparesis in Children. The Benefit of Conducting 4?Hours Scintigraphic Gastric Emptying Studies.