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Positive predictive value of serological diagnostic measures in celiac disease.
Clin Chem Lab Med 2010; 48(5):685-91CC

Abstract

BACKGROUND

Celiac disease (CD) antibodies, immunoglobulin A (IgA) anti-tissue transglutaminase (anti-tTG), IgA endomysium antibody (EMA), IgA and IgG anti-gliadin antibodies (IgA and IgG AGA) are first-line diagnostic tools used in selecting patients for duodenal biopsy. The goal of this study was to evaluate the diagnostic quality of serological testing for CD.

METHODS

CD serological tests (IgA and IgG AGA, anti-tTG and EMA) from 11,915 individuals were measured. Data were combined with clinical data and results of duodenal biopsy using a unique Danish personal identification number.

RESULTS

The positive predictive value (PPV) varied according to different combinations of positive CD antibodies, being highest when all antibodies were positive (97.6%). The anti-tTG concentration correlated strongly with EMA positivity, number of additional positive antibodies, and higher PPV. A logistic regression model predicted the probability of later biopsy-proven CD in relation to concentrations of IgA AGA and anti-tTG at initial serological screening.

CONCLUSIONS

The anti-tTG concentration at initial serological CD screening was highly informative in relation to EMA positivity, number of additional CD specific antibodies and PPV. Furthermore, in the high-risk group of patients investigated, the concentrations of anti-tTG and IgA AGA at initial serological screening could accurately predict the probability of future biopsy-proven CD.

Authors+Show Affiliations

Hans Christian Andersen Children's Hospital, Odense University Hospital, Denmark.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20201743

Citation

Toftedal, Peter, et al. "Positive Predictive Value of Serological Diagnostic Measures in Celiac Disease." Clinical Chemistry and Laboratory Medicine, vol. 48, no. 5, 2010, pp. 685-91.
Toftedal P, Nielsen C, Madsen JT, et al. Positive predictive value of serological diagnostic measures in celiac disease. Clin Chem Lab Med. 2010;48(5):685-91.
Toftedal, P., Nielsen, C., Madsen, J. T., Titlestad, K., Husby, S., & Lillevang, S. T. (2010). Positive predictive value of serological diagnostic measures in celiac disease. Clinical Chemistry and Laboratory Medicine, 48(5), pp. 685-91. doi:10.1515/CCLM.2010.136.
Toftedal P, et al. Positive Predictive Value of Serological Diagnostic Measures in Celiac Disease. Clin Chem Lab Med. 2010;48(5):685-91. PubMed PMID: 20201743.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Positive predictive value of serological diagnostic measures in celiac disease. AU - Toftedal,Peter, AU - Nielsen,Christian, AU - Madsen,Jonas Trolle, AU - Titlestad,Kjell, AU - Husby,Steffen, AU - Lillevang,Søren Thue, PY - 2010/3/6/entrez PY - 2010/3/6/pubmed PY - 2010/7/29/medline SP - 685 EP - 91 JF - Clinical chemistry and laboratory medicine JO - Clin. Chem. Lab. Med. VL - 48 IS - 5 N2 - BACKGROUND: Celiac disease (CD) antibodies, immunoglobulin A (IgA) anti-tissue transglutaminase (anti-tTG), IgA endomysium antibody (EMA), IgA and IgG anti-gliadin antibodies (IgA and IgG AGA) are first-line diagnostic tools used in selecting patients for duodenal biopsy. The goal of this study was to evaluate the diagnostic quality of serological testing for CD. METHODS: CD serological tests (IgA and IgG AGA, anti-tTG and EMA) from 11,915 individuals were measured. Data were combined with clinical data and results of duodenal biopsy using a unique Danish personal identification number. RESULTS: The positive predictive value (PPV) varied according to different combinations of positive CD antibodies, being highest when all antibodies were positive (97.6%). The anti-tTG concentration correlated strongly with EMA positivity, number of additional positive antibodies, and higher PPV. A logistic regression model predicted the probability of later biopsy-proven CD in relation to concentrations of IgA AGA and anti-tTG at initial serological screening. CONCLUSIONS: The anti-tTG concentration at initial serological CD screening was highly informative in relation to EMA positivity, number of additional CD specific antibodies and PPV. Furthermore, in the high-risk group of patients investigated, the concentrations of anti-tTG and IgA AGA at initial serological screening could accurately predict the probability of future biopsy-proven CD. SN - 1437-4331 UR - https://www.unboundmedicine.com/medline/citation/20201743/Positive_predictive_value_of_serological_diagnostic_measures_in_celiac_disease_ L2 - https://www.degruyter.com/doi/10.1515/CCLM.2010.136 DB - PRIME DP - Unbound Medicine ER -