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A reliable screening procedure for coeliac disease in clinical practice.
Scand J Gastroenterol 2002; 37(6):679-84SJ

Abstract

BACKGROUND

The main autoantigen recognized by the sera of patients with coeliac disease (CD) is tissue transglutaminase (tTG). A human-recombinant form of tTG was used to develop an ELISA to measure anti-tTG serum antibodies for the diagnosis of CD. Preliminary retrospective reports suggest that the human tTG-based ELISA could identify coeliac patients missed by the IgA-anti-endomysium antibody test (AEA). Whether the human recombinant tTG ELISA is sufficiently accurate to become the main diagnostic CD tool in everyday clinical practice is unknown. The objective was to determine, in a prospective study, the sensitivity and specificity of an ELISA test based on the use of human tTG compared with AEA, to analyse the discordant cases for HLA DQ2-8 and for clinical and intestinal biopsy characteristics.

METHODS

1106 patients referred to a gastrointestinal outpatient clinic for symptoms attributable to CD, 52 first-degree relatives of CD patients and 200 healthy controls were tested for both anti-human tTG and AEA antibodies.

RESULTS

Out of 1158 subjects, 146 were tested positive for anti-tTG antibodies and 140 were biopsy-proven coeliacs. The AEA test identified 126/1158 coeliacs who also tested positive for anti-tTG antibodies. The 14 patients missed by the AEA test carried the typical HLA-DQ for CD; they had normal levels of total serum IgA and had milder pathology than those with both anti-tTG and AEA positivity (P < 0001).

CONCLUSIONS

These results prove that human tTG-based ELISA is an excellent diagnostic tool for CD, for mass screening by both the specialist and the general clinic.

Authors+Show Affiliations

Dept of Reproductive and Development Science, IRCCS Burlo Garofolo, University of Trieste, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12126246

Citation

Trevisiol, C, et al. "A Reliable Screening Procedure for Coeliac Disease in Clinical Practice." Scandinavian Journal of Gastroenterology, vol. 37, no. 6, 2002, pp. 679-84.
Trevisiol C, Ventura A, Baldas V, et al. A reliable screening procedure for coeliac disease in clinical practice. Scand J Gastroenterol. 2002;37(6):679-84.
Trevisiol, C., Ventura, A., Baldas, V., Tommasini, A., Santon, D., Martelossi, S., ... Not, T. (2002). A reliable screening procedure for coeliac disease in clinical practice. Scandinavian Journal of Gastroenterology, 37(6), pp. 679-84.
Trevisiol C, et al. A Reliable Screening Procedure for Coeliac Disease in Clinical Practice. Scand J Gastroenterol. 2002;37(6):679-84. PubMed PMID: 12126246.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A reliable screening procedure for coeliac disease in clinical practice. AU - Trevisiol,C, AU - Ventura,A, AU - Baldas,V, AU - Tommasini,A, AU - Santon,D, AU - Martelossi,S, AU - Torre,G, AU - Berti,I, AU - Spanò,A, AU - Crovella,S, AU - Amoroso,A, AU - Sblattero,D, AU - Marzari,R, AU - Bradbury,A, AU - Not,T, PY - 2002/7/20/pubmed PY - 2003/1/11/medline PY - 2002/7/20/entrez SP - 679 EP - 84 JF - Scandinavian journal of gastroenterology JO - Scand. J. Gastroenterol. VL - 37 IS - 6 N2 - BACKGROUND: The main autoantigen recognized by the sera of patients with coeliac disease (CD) is tissue transglutaminase (tTG). A human-recombinant form of tTG was used to develop an ELISA to measure anti-tTG serum antibodies for the diagnosis of CD. Preliminary retrospective reports suggest that the human tTG-based ELISA could identify coeliac patients missed by the IgA-anti-endomysium antibody test (AEA). Whether the human recombinant tTG ELISA is sufficiently accurate to become the main diagnostic CD tool in everyday clinical practice is unknown. The objective was to determine, in a prospective study, the sensitivity and specificity of an ELISA test based on the use of human tTG compared with AEA, to analyse the discordant cases for HLA DQ2-8 and for clinical and intestinal biopsy characteristics. METHODS: 1106 patients referred to a gastrointestinal outpatient clinic for symptoms attributable to CD, 52 first-degree relatives of CD patients and 200 healthy controls were tested for both anti-human tTG and AEA antibodies. RESULTS: Out of 1158 subjects, 146 were tested positive for anti-tTG antibodies and 140 were biopsy-proven coeliacs. The AEA test identified 126/1158 coeliacs who also tested positive for anti-tTG antibodies. The 14 patients missed by the AEA test carried the typical HLA-DQ for CD; they had normal levels of total serum IgA and had milder pathology than those with both anti-tTG and AEA positivity (P < 0001). CONCLUSIONS: These results prove that human tTG-based ELISA is an excellent diagnostic tool for CD, for mass screening by both the specialist and the general clinic. SN - 0036-5521 UR - https://www.unboundmedicine.com/medline/citation/12126246/A_reliable_screening_procedure_for_coeliac_disease_in_clinical_practice_ L2 - http://www.tandfonline.com/doi/full/10.1080/00365520212513 DB - PRIME DP - Unbound Medicine ER -