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Antigliadin immunoglobulin A best in finding celiac disease in children younger than 18 months of age.
J Pediatr Gastroenterol Nutr 2008; 47(4):428-35JP

Abstract

OBJECTIVES

The aim was to investigate age-dependent serum levels and occurrence of elevated celiac disease (CD)-related antibodies in young children, to define the optimal serological procedure when selecting for small intestinal biopsy.

PATIENTS AND METHODS

Included were 428 children with biopsy verified CD (median age 16 months; range 7.5 months-14 years) and 216 controls (median age 2.7 years; range 8.5 months-14.6 years). Immunoglobulin (Ig) A antibodies against gliadin (AGA-IgA), tissue transglutaminase (tTG-IgA), and endomysium (EMA-IgA) were analysed.

RESULTS

Increased serum AGA-IgA levels were found in 411 of 428 CD cases, tTG-IgA in 385 of 428, and EMA-IgA in 383 of 428. In the control group, 11 of 216 had increased levels of AGA-IgA, 5 of 216 of tTG-IgA, and 8 of 216 of EMA-IgA. In CD children younger than 18 months, elevated AGA-IgA occurred in 97% and elevated tTG-IgA and EMA-IgA were found in 83% of the cases. Conversely, in CD children older than 18 months, elevated AGA-IgA occurred in 94%, and elevated tTG-IgA and EMA-IgA were found in 99% of the cases.

CONCLUSIONS

In children older than 18 months, both tTG-IgA and EMA-IgA are sufficiently accurate to be used as a single antibody marker, whereas a large proportion of younger children with CD lack these antibodies. Therefore, when selecting children for small intestinal biopsy, the detection of a combination of AGA-IgA and tTG-IgA is optimal for identifying untreated CD in children younger than 18 months.

Authors+Show Affiliations

Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden. carina.lagerqvist@pediatri.umu.seNo 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

18852634

Citation

Lagerqvist, Carina, et al. "Antigliadin Immunoglobulin a Best in Finding Celiac Disease in Children Younger Than 18 Months of Age." Journal of Pediatric Gastroenterology and Nutrition, vol. 47, no. 4, 2008, pp. 428-35.
Lagerqvist C, Dahlbom I, Hansson T, et al. Antigliadin immunoglobulin A best in finding celiac disease in children younger than 18 months of age. J Pediatr Gastroenterol Nutr. 2008;47(4):428-35.
Lagerqvist, C., Dahlbom, I., Hansson, T., Jidell, E., Juto, P., Olcén, P., ... Ivarsson, A. (2008). Antigliadin immunoglobulin A best in finding celiac disease in children younger than 18 months of age. Journal of Pediatric Gastroenterology and Nutrition, 47(4), pp. 428-35. doi:10.1097/MPG.0b013e31817d80f4.
Lagerqvist C, et al. Antigliadin Immunoglobulin a Best in Finding Celiac Disease in Children Younger Than 18 Months of Age. J Pediatr Gastroenterol Nutr. 2008;47(4):428-35. PubMed PMID: 18852634.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antigliadin immunoglobulin A best in finding celiac disease in children younger than 18 months of age. AU - Lagerqvist,Carina, AU - Dahlbom,Ingrid, AU - Hansson,Tony, AU - Jidell,Erik, AU - Juto,Per, AU - Olcén,Per, AU - Stenlund,Hans, AU - Hernell,Olle, AU - Ivarsson,Anneli, PY - 2008/10/15/pubmed PY - 2009/2/10/medline PY - 2008/10/15/entrez SP - 428 EP - 35 JF - Journal of pediatric gastroenterology and nutrition JO - J. Pediatr. Gastroenterol. Nutr. VL - 47 IS - 4 N2 - OBJECTIVES: The aim was to investigate age-dependent serum levels and occurrence of elevated celiac disease (CD)-related antibodies in young children, to define the optimal serological procedure when selecting for small intestinal biopsy. PATIENTS AND METHODS: Included were 428 children with biopsy verified CD (median age 16 months; range 7.5 months-14 years) and 216 controls (median age 2.7 years; range 8.5 months-14.6 years). Immunoglobulin (Ig) A antibodies against gliadin (AGA-IgA), tissue transglutaminase (tTG-IgA), and endomysium (EMA-IgA) were analysed. RESULTS: Increased serum AGA-IgA levels were found in 411 of 428 CD cases, tTG-IgA in 385 of 428, and EMA-IgA in 383 of 428. In the control group, 11 of 216 had increased levels of AGA-IgA, 5 of 216 of tTG-IgA, and 8 of 216 of EMA-IgA. In CD children younger than 18 months, elevated AGA-IgA occurred in 97% and elevated tTG-IgA and EMA-IgA were found in 83% of the cases. Conversely, in CD children older than 18 months, elevated AGA-IgA occurred in 94%, and elevated tTG-IgA and EMA-IgA were found in 99% of the cases. CONCLUSIONS: In children older than 18 months, both tTG-IgA and EMA-IgA are sufficiently accurate to be used as a single antibody marker, whereas a large proportion of younger children with CD lack these antibodies. Therefore, when selecting children for small intestinal biopsy, the detection of a combination of AGA-IgA and tTG-IgA is optimal for identifying untreated CD in children younger than 18 months. SN - 1536-4801 UR - https://www.unboundmedicine.com/medline/citation/18852634/Antigliadin_immunoglobulin_A_best_in_finding_celiac_disease_in_children_younger_than_18_months_of_age_ L2 - http://Insights.ovid.com/pubmed?pmid=18852634 DB - PRIME DP - Unbound Medicine ER -