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Antibodies against synthetic deamidated gliadin peptides as predictors of celiac disease: prospective assessment in an adult population with a high pretest probability of disease.
Clin Chem. 2007 Dec; 53(12):2186-92.CC

Abstract

BACKGROUND

Noninvasive serologic tests have shown high diagnostic accuracy for celiac disease (CD) in selected populations. Our aim was to determine prospectively the performance of CD-related serology in individuals undergoing intestinal biopsy because of clinical suspicion of small-bowel disorders.

METHODS

We enrolled 141 unselected consecutive adult patients attending a small-bowel disease clinic. Patients underwent endoscopy and biopsy; serum samples were obtained at that time for measurements of anti-tissue transglutaminase (a-tTG), IgA and IgG anti-deamidated gliadin-related peptide (a-DGP), and IgA antiactin antibodies (AAAs). Characterization of patients was based on histological criteria (Marsh type II lesion or greater).

RESULTS

The prevalence of CD was 42.5%. Sensitivity, specificity, and positive and negative predictive values were >90% for most assays. Diagnostic accuracy based on ROC curve analysis was similar for all assays [area under the curve (95% CI): 0.996 (0.967-0.998) for a-tTG, 0.995 (0.964-0.998) for IgA a-DGP, 0.989 (0.954-0.999) for IgG a-DGP, 0.996 (0.966-0.998) for blended conjugated of IgA + IgG a-DGP in a single assay, and 0.967 (0.922-0.990) for AAA]. The combinations of 2 tests, IgG a-DGP plus IgA a-tTG or the single blended conjugate detecting IgA + IgG a-DGP plus IgA a-tTG had 100% positive and negative predictive values if concentrations of both tests in either combination were above or below the cutoff.

CONCLUSIONS

In a population with high pretest probability, the newly developed a-DGP tests have diagnostic accuracy that is at least equivalent to that of established assays.

Authors+Show Affiliations

Department of Medicine, Hospital de Gastroenterología "Dr. Carlos Bonorino Udaondo", Buenos Aires, Argentina.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 available

Pub Type(s)

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

Language

eng

PubMed ID

17901114

Citation

Niveloni, Sonia, et al. "Antibodies Against Synthetic Deamidated Gliadin Peptides as Predictors of Celiac Disease: Prospective Assessment in an Adult Population With a High Pretest Probability of Disease." Clinical Chemistry, vol. 53, no. 12, 2007, pp. 2186-92.
Niveloni S, Sugai E, Cabanne A, et al. Antibodies against synthetic deamidated gliadin peptides as predictors of celiac disease: prospective assessment in an adult population with a high pretest probability of disease. Clin Chem. 2007;53(12):2186-92.
Niveloni, S., Sugai, E., Cabanne, A., Vazquez, H., Argonz, J., Smecuol, E., Moreno, M. L., Nachman, F., Mazure, R., Kogan, Z., Gomez, J. C., Mauriño, E., & Bai, J. C. (2007). Antibodies against synthetic deamidated gliadin peptides as predictors of celiac disease: prospective assessment in an adult population with a high pretest probability of disease. Clinical Chemistry, 53(12), 2186-92.
Niveloni S, et al. Antibodies Against Synthetic Deamidated Gliadin Peptides as Predictors of Celiac Disease: Prospective Assessment in an Adult Population With a High Pretest Probability of Disease. Clin Chem. 2007;53(12):2186-92. PubMed PMID: 17901114.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antibodies against synthetic deamidated gliadin peptides as predictors of celiac disease: prospective assessment in an adult population with a high pretest probability of disease. AU - Niveloni,Sonia, AU - Sugai,Emilia, AU - Cabanne,Ana, AU - Vazquez,Horacio, AU - Argonz,Julio, AU - Smecuol,Edgardo, AU - Moreno,María L, AU - Nachman,Fabio, AU - Mazure,Roberto, AU - Kogan,Zulema, AU - Gomez,Juan C, AU - Mauriño,Eduardo, AU - Bai,Julio C, Y1 - 2007/09/27/ PY - 2007/9/29/pubmed PY - 2008/3/11/medline PY - 2007/9/29/entrez SP - 2186 EP - 92 JF - Clinical chemistry JO - Clin. Chem. VL - 53 IS - 12 N2 - BACKGROUND: Noninvasive serologic tests have shown high diagnostic accuracy for celiac disease (CD) in selected populations. Our aim was to determine prospectively the performance of CD-related serology in individuals undergoing intestinal biopsy because of clinical suspicion of small-bowel disorders. METHODS: We enrolled 141 unselected consecutive adult patients attending a small-bowel disease clinic. Patients underwent endoscopy and biopsy; serum samples were obtained at that time for measurements of anti-tissue transglutaminase (a-tTG), IgA and IgG anti-deamidated gliadin-related peptide (a-DGP), and IgA antiactin antibodies (AAAs). Characterization of patients was based on histological criteria (Marsh type II lesion or greater). RESULTS: The prevalence of CD was 42.5%. Sensitivity, specificity, and positive and negative predictive values were >90% for most assays. Diagnostic accuracy based on ROC curve analysis was similar for all assays [area under the curve (95% CI): 0.996 (0.967-0.998) for a-tTG, 0.995 (0.964-0.998) for IgA a-DGP, 0.989 (0.954-0.999) for IgG a-DGP, 0.996 (0.966-0.998) for blended conjugated of IgA + IgG a-DGP in a single assay, and 0.967 (0.922-0.990) for AAA]. The combinations of 2 tests, IgG a-DGP plus IgA a-tTG or the single blended conjugate detecting IgA + IgG a-DGP plus IgA a-tTG had 100% positive and negative predictive values if concentrations of both tests in either combination were above or below the cutoff. CONCLUSIONS: In a population with high pretest probability, the newly developed a-DGP tests have diagnostic accuracy that is at least equivalent to that of established assays. SN - 0009-9147 UR - https://www.unboundmedicine.com/medline/citation/17901114/Antibodies_against_synthetic_deamidated_gliadin_peptides_as_predictors_of_celiac_disease:_prospective_assessment_in_an_adult_population_with_a_high_pretest_probability_of_disease_ L2 - http://www.clinchem.org/cgi/pmidlookup?view=long&pmid=17901114 DB - PRIME DP - Unbound Medicine ER -