Document Detail

Quality not quantity for transglutaminase antibody 2: the performance of an endomysial and tissue transglutaminase test in screening coeliac disease remains stable over time.
MedLine Citation:
PMID:  23199329     Owner:  NLM     Status:  MEDLINE    
National Institute of Clinical Excellence (NICE) and European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) guidance for the diagnosis of coeliac disease has been published. However, there is some controversy regarding the advice on the use of stratifying levels of immunoglobulin (IgA) tissue transglutaminase antibody (TG2) test positivity in the absence of test standardization and the vagueness of the indication to test equivocal samples. Using repeat service audit, we demonstrate that a combination of TG2 followed by IgA endomysial antibodies (EMA) is the best strategy for all degrees of mucosal abnormality using our test combination. Reliance upon immunoassay titre is not as effective, and cannot be applied consistently across populations in the absence of assay standardization. Guidelines advocating the use of tests should involve experts in laboratory diagnostics and external quality assurance to ensure that errors of generalization do not occur and that test performance is achievable in routine diagnostic use.
K Swallow; G Wild; R Sargur; D S Sanders; I Aziz; A D Hopper; W Egner
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical and experimental immunology     Volume:  171     ISSN:  1365-2249     ISO Abbreviation:  Clin. Exp. Immunol.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2012-12-03     Completed Date:  2013-02-19     Revised Date:  2014-01-10    
Medline Journal Info:
Nlm Unique ID:  0057202     Medline TA:  Clin Exp Immunol     Country:  England    
Other Details:
Languages:  eng     Pagination:  100-6     Citation Subset:  IM    
Copyright Information:
© 2012 British Society for Immunology.
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MeSH Terms
Autoantibodies / analysis*,  immunology
Celiac Disease / diagnosis*,  immunology
Clinical Audit
Diagnostic Errors
Enzyme-Linked Immunosorbent Assay
GTP-Binding Proteins / immunology*
Immunoglobulin A / analysis,  immunology
Immunoglobulin G / analysis,  immunology
Intestinal Mucosa / chemistry,  immunology
Mass Screening / methods*
Muscle Fibers, Skeletal / chemistry,  immunology
Quality Control
Sensitivity and Specificity
Serologic Tests
Transglutaminases / immunology*
Reg. No./Substance:
0/Autoantibodies; 0/Immunoglobulin A; 0/Immunoglobulin G; EC 2.3.2.-/transglutaminase 2; EC; EC 3.6.1.-/GTP-Binding Proteins

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

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