| Coeliac Disease: The New Proposed ESPGHAN Diagnostic Criteria Do Work Well in A Selected Population. | |
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MedLine Citation:
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PMID: 23111763 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND:: The need for an early and accurate diagnosis in Coeliac disease (CD) has focused the attention on new diagnostic approaches, based on the efficiency of serological markers (SM) and the high negative predictive value of HLA non DQ2/8. METHODS:: We performed a retrospective review of all patients suspicious of having CD who had undergone a small bowel biopsy in our Gastroenterology Unit. All symptomatic children with SM at time of biopsy: immunoglobulin A-tissue transglutaminase antibody (tTGA), endomysial antibody (EMA) and HLA genotype were included. Triple Test (TT) was positive if tTGA was 10x the upper limit of normal range, plus positive EMA plus HLA DQ2/DQ8. RESULTS:: 150 patients met the inclusion criteria and were enrolled in the study. 116 were positive for the TT: 113/116 (97.4%) had a Marsh 2/3 histological lesion and had been considered to have CD. Thus PPV of the TT was 97.4%. The other three cases (2.6%) had Marsh 0/1 lesion, so we consider them as false positives for the TT. However, on follow up, all three children developed histological damage after a gluten challenge. Finally, PPV of the TT was 100%.34 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 support the view that in selected children who are symptomatic and positive for the Triple Test, CD diagnosis could be established independently of histological findings. |
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Authors:
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Gabriela Klapp; Etna Masip; Miguel Bolonio; Ester Donat; Begoña Polo; David Ramos; Carmen Ribes-Koninckx |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-10-29 |
Journal Detail:
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Title: Journal of pediatric gastroenterology and nutrition Volume: - ISSN: 1536-4801 ISO Abbreviation: J. Pediatr. Gastroenterol. Nutr. Publication Date: 2012 Oct |
Date Detail:
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Created Date: 2012-10-31 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8211545 Medline TA: J Pediatr Gastroenterol Nutr Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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*Pediatric Gastroenterology & Hepatology, La Fe University Hospital, Valencia, Spain †Degree in Biology, Pediatric Gastroenterology & Hepatology Investigation Laboratorium, La Fe University Hospital, Valencia, Spain ‡Pathology Department, La Fe University Hospital, Valencia, Spain. |
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