Real-Life Performance of Multiplex Celiac Antibody Test in the Diagnosis of Pediatric Celiac Disease

Introduction. Celiac disease (CD) is an autoimmune disease triggered by gluten in genetically predisposed individuals. Despite the increasing prevalence of CD, many patients remain undiagnosed. Standard serology tests are expensive and invasive, so several point-of-care tests (POC) for CD have been developed. We aimed to determine the prevalence of CD in first-grade pupils in Primorje-Gorski Kotar County, Croatia, using a POC test. Methods. A Biocard celiac test that detects IgA antibodies to tissue transglutaminase in whole blood was used to screen for celiac disease in healthy first-grade children born in 2011 and 2012 who consumed gluten without restrictions. Results. 1478 children were tested, and none of them were tested positive with a rapid test. In 10 children (0,6%), IgA deficiency has been suspected; only 4 of them agreed to be tested further for total IgA, anti-tTG, and anti-DGP antibodies. IgA deficiency was confirmed in 3 patients, and in all 4 children, CD has been excluded. Conclusion. Our results have not confirmed the usefulness of the POC test in screening the general population of first-grade schoolchildren. Further research is needed to establish the true epidemiology of CD in Primorje-Gorski Kotar County and to confirm the value of the rapid test in comparison with standard antibody CD testing.

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Application of the Biopsy-Sparing ESPGHAN Guidelines for Celiac Disease Diagnosis in Adults: A Real-Life Study

Digestive Diseases and Sciences ◽

10.1007/s10620-017-4672-1 ◽

2017 ◽

Vol 62 (9) ◽

pp. 2433-2439 ◽

Cited By ~ 16

Author(s):

Konstantinos Efthymakis ◽

Mariaelena Serio ◽

Angelo Milano ◽

Francesco Laterza ◽

Antonella Bonitatibus ◽

...

Keyword(s):

Celiac Disease ◽

Real Life ◽

Disease Diagnosis ◽

Life Study ◽

Espghan Guidelines ◽

Real Life Study ◽

Celiac Disease Diagnosis

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Prevalence of celiac disease among first degree relatives of Brazilian celiac patients

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032008000100013 ◽

2008 ◽

Vol 45 (1) ◽

pp. 69-72 ◽

Cited By ~ 18

Author(s):

Patrícia Lopes de Almeida ◽

Lenora Gandolfi ◽

Inês Cristina Modelli ◽

Rita de Cássia Martins ◽

Rodrigo Coutinho de Almeida ◽

...

Keyword(s):

Celiac Disease ◽

Tissue Transglutaminase ◽

Antibody Test ◽

Autoimmune Disorder ◽

University Hospital ◽

Serological Tests ◽

Intestinal Lesion ◽

Serological Screening ◽

First Degree Relatives ◽

Small Intestinal

BACKGROUND: Several studies have shown that celiac disease, an autoimmune disorder that occurs in genetically susceptible individuals, is highly prevalent among relatives of celiac patients. AIM: To determine the prevalence of celiac disease in a group of first degree relatives of Brazilian celiac patients. METHODS: First degree relatives of celiac patients attending the Brasilia University Hospital Pediatric Gastroenterology Outpatient Clinic or the Celiac Disease Investigation Center, Brasília, DF, Brazil, between March 2001 and November 2004 were invited to undergo serological screening for celiac disease applying the IgA anti-endomysium antibody test (IgA-EMA). All positive IgA-EMA sera underwent a second screening using the IgA anti-tissue transglutaminase antibodies test. Duodenal or small intestinal biopsies were performed in all subjects positive to serological testing. Biopsy samples were classified as type (O) normal, (I) infiltrative, (II) infiltrative hyperplastic, (III) flat destructive, and (IV) atrophic hypoplastic. The final diagnosis was ascertained in subjects showing positive serological tests and a grade I to III small intestinal lesion. RESULTS: Nine new cases of celiac disease were found among the 188 first degree relatives tested (4.8%). CONCLUSION: The present study confirms the high prevalence of celiac disease among first degree celiac patients’ relatives and reinforces the need of extensive diagnostic screening in this specific group.

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Real-Life Case Finding of Undiagnosed Celiac Disease: Exposing the Celiac Ugly Truth?

The American Journal of Gastroenterology ◽

10.14309/00000434-201610001-01047 ◽

2016 ◽

Vol 111 ◽

pp. S455

Author(s):

Isabel A. Hujoel ◽

Carol Van Dyke ◽

Tricia Brantner ◽

Joseph J. Larson ◽

Katherine King ◽

...

Keyword(s):

Celiac Disease ◽

Real Life ◽

Case Finding

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Improved method for serological testing in celiac disease: IgA anti-endomysium antibody test: a comparison between monkey oesophagus and human umbilical cord as substrate in indirect immunofluorescence test

Scandinavian Journal of Clinical and Laboratory Investigation ◽

10.1080/00365519850186166 ◽

1998 ◽

Vol 58 (7) ◽

pp. 547-554 ◽

Cited By ~ 4

Author(s):

W. Amara ◽

A. Husebekk

Keyword(s):

Celiac Disease ◽

Umbilical Cord ◽

Antibody Test ◽

Human Umbilical Cord ◽

Serological Testing ◽

Improved Method ◽

Immunofluorescence Test ◽

Indirect Immunofluorescence Test ◽

Monkey Oesophagus ◽

Endomysium Antibody

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Clinical Onset of Celiac Disease after an Episode ofCampylobacter jejuniEnteritis

Canadian Journal of Gastroenterology ◽

10.1155/2007/169591 ◽

2007 ◽

Vol 21 (7) ◽

pp. 453-455 ◽

Cited By ~ 34

Author(s):

EF Verdu ◽

M Mauro ◽

J Bourgeois ◽

D Armstrong

Keyword(s):

Celiac Disease ◽

Tissue Transglutaminase ◽

Present Report ◽

Immunoglobulin A ◽

Antibody Test ◽

Susceptible Host ◽

Vitamin Deficiencies ◽

Clinical Onset ◽

Infectious Gastroenteritis ◽

Repeat Endoscopy

The present report describes a young woman with no previous gastrointestinal complaints who was initially diagnosed with postinfective irritable bowel syndrome (IBS) after a confirmed case ofCampylobacter jejunienteritis. However, because of persistent diarrhea, new-onset bloating and the development of iron and vitamin deficiencies, serological markers for celiac disease (CD) were evaluated. A positive tissue transglutaminase immunoglobulin A antibody test and repeat endoscopy with duodenal biopsy showing a Marsh IIIa lesion confirmed the diagnosis of CD. Infectious gastroenteritis is a well-established risk factor for the development of IBS, and there is recent evidence that it could play a role in the initiation and exacerbation of inflammatory bowel disease. The present case suggests that the clinical expression of CD can be unmasked by an acute gastrointestinal infection and supports the hypothesis that environmental factors other than gliadin may play a role in the clinical onset of CD in a genetically susceptible host. The increasing availability of serological testing and upper endoscopy has led to increasingly frequent diagnoses of CD and recognition that it may mimic IBS. The present case findings suggest that CD should be considered in the differential diagnosis of persistent IBS-like symptoms after an episode of infectious gastroenteritis.

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Antiendomysial Antibody Test Reliability in Children With Frequent Diarrhea and Malnutrition: Is It Celiac Disease?

Journal of Pediatric Gastroenterology and Nutrition ◽

10.1097/00005176-200110000-00013 ◽

2001 ◽

Vol 33 (4) ◽

pp. 483-487 ◽

Cited By ~ 5

Author(s):

Lenora Gandolfi ◽

Carlo Catassi ◽

Steven Garcia ◽

Ines Cristina Modelli ◽

Dioclecio Campos ◽

...

Keyword(s):

Celiac Disease ◽

Antibody Test ◽

Test Reliability

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Hepatobiliary Disorders in Celiac Disease: An Update

International Journal of Hepatology ◽

10.4061/2011/438184 ◽

2011 ◽

Vol 2011 ◽

pp. 1-7 ◽

Cited By ~ 8

Author(s):

Kaushal K. Prasad ◽

Uma Debi ◽

Saroj K. Sinha ◽

Chander K. Nain ◽

Kartar Singh

Keyword(s):

Celiac Disease ◽

Liver Disease ◽

Liver Enzyme ◽

Wide Spectrum ◽

Serum Antibody ◽

Gastrointestinal Symptoms ◽

Antibody Test ◽

Cholestatic Liver Disease ◽

Nonalcoholic Fatty Liver ◽

High Index Of Suspicion

This communication reviews recent literature and summarizes hepatobiliary abnormalities that may complicate the clinical course of celiac disease. A wide spectrum of hepatobiliary diseases has been described, including asymptomatic elevations of liver enzyme levels, nonspecific hepatitis, nonalcoholic fatty liver disease, and autoimmune and cholestatic liver disease. Moreover, in the majority of patients, liver enzyme levels will normalize on a gluten-free diet. In addition, celiac disease may be associated with rare hepatic complications, such as hepatic T-cell lymphoma. Because many celiac patients do not have overt gastrointestinal symptoms, a high index of suspicion is required. Simple methods of detecting celiac disease such as serum antibody tests help in the early identification of the disease, thus preventing serious complications of the disorder. The IgG DGP antibody test and IgA tTG antibody test used in combination are an excellent screening test for suspected cases of celiac disease.

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Celiac Disease: Are Endomysial Antibody Test Results Being Used Appropriately?

Clinical Chemistry ◽

10.1373/clinchem.2007.090308 ◽

2007 ◽

Vol 53 (10) ◽

pp. 1775-1781 ◽

Cited By ~ 3

Author(s):

Kelly E McGowan ◽

Martha E Lyon ◽

Steven D Loken ◽

J Decker Butzner

Keyword(s):

Celiac Disease ◽

Antibody Test ◽

Gluten Free Diet ◽

Intestinal Biopsy ◽

Gluten Free ◽

Test Results ◽

Male And Female ◽

Serum Iga ◽

Number Of Patients

Abstract Background: The aim of this study was to retrospectively examine how positive IgA-endomysial antibody (EMA) test results for celiac disease were being interpreted and acted on by physicians in the Calgary Health Region. Methods: We reviewed consecutive EMA test results, with or without a serum IgA, obtained during a 17-month period. Seropositive tests were cross-referenced to the surgical database to determine the number of patients who underwent intestinal biopsy and the results of the biopsy. We sent questionnaires to the ordering physicians of positive tests with no record of intestinal biopsy. Results: Among 11 716 EMA tests in 9533 patients, 349 results were positive in 313 patients (3%). Intestinal biopsies were performed in 218 (70%) of the seropositive patients; 194 of them were diagnostic of celiac disease. Celiac disease was also found in 10 EMA-negative patients. Of the 109 positive tests performed in 95 patients with no subsequent biopsy, 28 had appropriate indications to not perform a biopsy; the most common reason being that the test had been ordered to follow up on a previous biopsy-proven diagnosis of celiac disease (n = 21). For 33 other positive test results without a subsequent biopsy, management appeared to be inappropriate, most commonly (n = 21) because of a recommendation to follow a gluten-free diet despite lack of a tissue diagnosis of celiac disease. For the remaining 48 positive EMA results, administrative issues prevented evaluation (n = 19), the patients refused further evaluation (n = 11), or physician surveys were not returned (n = 18). Conclusions: Celiac disease affected 2% of patients, with a similar prevalence in male and female patients. Most positive EMA tests (77%) were appropriately managed by physicians. Beginning a gluten-free diet without biopsy or failing to follow up on a positive EMA test remain common errors of management.

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