PMID- 25719330
OWN - NLM
STAT- MEDLINE
DCOM- 20160711
LR  - 20211203
IS  - 1437-4331 (Electronic)
IS  - 1434-6621 (Linking)
VI  - 53
IP  - 10
DP  - 2015 Sep 1
TI  - Combining antibody tests and taking into account antibody levels improves 
      serologic diagnosis of celiac disease.
PG  - 1537-46
LID - 10.1515/cclm-2013-1099 [doi]
AB  - BACKGROUND: The European Society for Pediatric Gastroenterology and Nutrition 
      states that if IgA anti-tissue transglutaminase (tTG) exceeds 10 times the upper 
      limit of normal (ULN), there is the possibility to diagnose celiac disease (CD) 
      without duodenal biopsy, if supported by anti-endomysium testing and human 
      leukocyte antigen (HLA) typing. We aimed to evaluate whether combining IgA tTG 
      and IgG anti-deamidated gliadin peptide (DGP) antibody testing and taking into 
      account the antibody levels improves clinical interpretation. METHODS: We 
      calculated likelihood ratios for various test result combinations using data 
      obtained from newly diagnosed CD patients (n=156) [13 children <2 years, 45 
      children between 2 and 16 years, and 98 adults (>16 years)] and 974 disease 
      controls. All patients and controls underwent duodenal biopsy. IgA anti-tTG and 
      IgG anti-DGP assays were from Thermo Fisher and Inova. RESULTS: Likelihood ratios 
      for CD markedly increased with double positivity and increasing antibody levels 
      of IgA anti-tTG and IgG anti-DGP. Patients with double positivity and high 
      antibody levels (>3 times, >10 times ULN) had a high probability for having CD 
      (likelihood ratio >/=649 for >3 times ULN and infinity for >10 times ULN). The fraction of 
      CD patients with double positivity and high antibody levels was 59%-67% 
      (depending on the assay) for >3 ULN and 33%-36% (depending on the assay) for >10 
      ULN, respectively. This fraction was significantly higher in children with CD 
      than in adults. CONCLUSIONS: Combining IgG anti-DGP with IgA anti-tTG and 
      defining thresholds for antibody levels improves the serologic diagnosis of CD.
FAU - Oyaert, Matthijs
AU  - Oyaert M
FAU - Vermeersch, Pieter
AU  - Vermeersch P
FAU - De Hertogh, Gert
AU  - De Hertogh G
FAU - Hiele, Martin
AU  - Hiele M
FAU - Vandeputte, Nathalie
AU  - Vandeputte N
FAU - Hoffman, Ilse
AU  - Hoffman I
FAU - Bossuyt, Xavier
AU  - Bossuyt X
LA  - eng
PT  - Journal Article
PL  - Germany
TA  - Clin Chem Lab Med
JT  - Clinical chemistry and laboratory medicine
JID - 9806306
RN  - 0 (Antibodies, Anti-Idiotypic)
RN  - 0 (Immunoglobulin A)
RN  - 0 (Immunoglobulin G)
RN  - 0 (anti-IgA)
RN  - 0 (anti-IgG)
RN  - 9007-90-3 (Gliadin)
RN  - EC 2.3.2.13 (Protein Glutamine gamma Glutamyltransferase 2)
RN  - EC 2.3.2.13 (Transglutaminases)
RN  - EC 3.6.1.- (GTP-Binding Proteins)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Antibodies, Anti-Idiotypic/immunology
MH  - Case-Control Studies
MH  - Celiac Disease/blood/*diagnosis/*immunology
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - GTP-Binding Proteins/*immunology
MH  - Gliadin/*immunology
MH  - Humans
MH  - Immunoglobulin A/immunology
MH  - Immunoglobulin G/immunology
MH  - Infant
MH  - Male
MH  - Protein Glutamine gamma Glutamyltransferase 2
MH  - Sensitivity and Specificity
MH  - Transglutaminases/*immunology
MH  - Young Adult
EDAT- 2015/02/27 06:00
MHDA- 2016/07/12 06:00
CRDT- 2015/02/27 06:00
PHST- 2013/12/21 00:00 [received]
PHST- 2015/01/09 00:00 [accepted]
PHST- 2015/02/27 06:00 [entrez]
PHST- 2015/02/27 06:00 [pubmed]
PHST- 2016/07/12 06:00 [medline]
AID - /j/cclm.ahead-of-print/cclm-2013-1099/cclm-2013-1099.xml [pii]
AID - 10.1515/cclm-2013-1099 [doi]
PST - ppublish
SO  - Clin Chem Lab Med. 2015 Sep 1;53(10):1537-46. doi: 10.1515/cclm-2013-1099.