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Diagnostic value of anti-deamidated gliadin peptide IgG antibodies for celiac disease in children and IgA-deficient patients.
J Pediatr Gastroenterol Nutr. 2012 Jul; 55(1):50-5.JP

Abstract

OBJECTIVES

The aim of the study was to analyze the diagnostic performance of anti-deamidated gliadin peptide (dGp) immunoglobulin (Ig) G and IgA regarding the age at celiac disease (CD) diagnosis and the anti-dGp IgG usefulness for diagnosing CD IgA-deficient patients.

METHODS

Anti-dGp IgG and IgA and anti-native gliadin (nGlia) IgA were determined by enzyme fluoroimmunoassay in 100 newly diagnosed anti-tissue transglutaminase (tTG) IgA-positive pediatric and adult patients with CD and in 100 age-matched patients with other digestive pathologies. Anti-dGp IgG was evaluated in 6 CD IgA-deficient patients.

RESULTS

When analyzing all of the patients, the anti-dGp IgG assay showed higher diagnostic accuracy (area under receiver operating characteristic curve), specificity, and positive predictive value than anti-dGp IgA and anti-nGlia IgA. All of the diagnostic parameters corresponding to anti-dGp IgG reached the same values as anti-tTG IgA in children 7 years or younger. In older patients, both anti-dGp isotypes showed an inverse behavior, IgG having a higher specificity and positive predictive value but a lower sensitivity and negative predictive value than IgA. Anti-dGp levels were associated with the severity of intestinal lesions, and an inverse association was found regarding age at diagnosis. Both anti-dGp IgG and IgA were found to be positive in the 9 patients with minimal intestinal changes included in the study. All of the patients with CD with IgA deficiency were positive for anti-dGp IgG.

CONCLUSIONS

The diagnostic performance of anti-dGp depends on the antibody isotype and on the age at CD diagnosis, anti-dGp IgG being a serological marker at least as useful as anti-tTG IgA for detecting CD in children ages 7 years or younger. Our data also indicate that anti-dGp IgG can improve the diagnosis of IgA-deficient patients.

Authors+Show Affiliations

Department of Immunology, Hospital Universitario Central de Asturias, Oviedo, Spain. lourdes.mozo@sespa.princast.esNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22197936

Citation

Mozo, Lourdes, et al. "Diagnostic Value of Anti-deamidated Gliadin Peptide IgG Antibodies for Celiac Disease in Children and IgA-deficient Patients." Journal of Pediatric Gastroenterology and Nutrition, vol. 55, no. 1, 2012, pp. 50-5.
Mozo L, Gómez J, Escanlar E, et al. Diagnostic value of anti-deamidated gliadin peptide IgG antibodies for celiac disease in children and IgA-deficient patients. J Pediatr Gastroenterol Nutr. 2012;55(1):50-5.
Mozo, L., Gómez, J., Escanlar, E., Bousoño, C., & Gutiérrez, C. (2012). Diagnostic value of anti-deamidated gliadin peptide IgG antibodies for celiac disease in children and IgA-deficient patients. Journal of Pediatric Gastroenterology and Nutrition, 55(1), 50-5. https://doi.org/10.1097/MPG.0b013e31824703c7
Mozo L, et al. Diagnostic Value of Anti-deamidated Gliadin Peptide IgG Antibodies for Celiac Disease in Children and IgA-deficient Patients. J Pediatr Gastroenterol Nutr. 2012;55(1):50-5. PubMed PMID: 22197936.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diagnostic value of anti-deamidated gliadin peptide IgG antibodies for celiac disease in children and IgA-deficient patients. AU - Mozo,Lourdes, AU - Gómez,Jesús, AU - Escanlar,Esther, AU - Bousoño,Carlos, AU - Gutiérrez,Carmen, PY - 2011/12/27/entrez PY - 2011/12/27/pubmed PY - 2012/12/10/medline SP - 50 EP - 5 JF - Journal of pediatric gastroenterology and nutrition JO - J. Pediatr. Gastroenterol. Nutr. VL - 55 IS - 1 N2 - OBJECTIVES: The aim of the study was to analyze the diagnostic performance of anti-deamidated gliadin peptide (dGp) immunoglobulin (Ig) G and IgA regarding the age at celiac disease (CD) diagnosis and the anti-dGp IgG usefulness for diagnosing CD IgA-deficient patients. METHODS: Anti-dGp IgG and IgA and anti-native gliadin (nGlia) IgA were determined by enzyme fluoroimmunoassay in 100 newly diagnosed anti-tissue transglutaminase (tTG) IgA-positive pediatric and adult patients with CD and in 100 age-matched patients with other digestive pathologies. Anti-dGp IgG was evaluated in 6 CD IgA-deficient patients. RESULTS: When analyzing all of the patients, the anti-dGp IgG assay showed higher diagnostic accuracy (area under receiver operating characteristic curve), specificity, and positive predictive value than anti-dGp IgA and anti-nGlia IgA. All of the diagnostic parameters corresponding to anti-dGp IgG reached the same values as anti-tTG IgA in children 7 years or younger. In older patients, both anti-dGp isotypes showed an inverse behavior, IgG having a higher specificity and positive predictive value but a lower sensitivity and negative predictive value than IgA. Anti-dGp levels were associated with the severity of intestinal lesions, and an inverse association was found regarding age at diagnosis. Both anti-dGp IgG and IgA were found to be positive in the 9 patients with minimal intestinal changes included in the study. All of the patients with CD with IgA deficiency were positive for anti-dGp IgG. CONCLUSIONS: The diagnostic performance of anti-dGp depends on the antibody isotype and on the age at CD diagnosis, anti-dGp IgG being a serological marker at least as useful as anti-tTG IgA for detecting CD in children ages 7 years or younger. Our data also indicate that anti-dGp IgG can improve the diagnosis of IgA-deficient patients. SN - 1536-4801 UR - https://www.unboundmedicine.com/medline/citation/22197936/Diagnostic_value_of_anti_deamidated_gliadin_peptide_IgG_antibodies_for_celiac_disease_in_children_and_IgA_deficient_patients_ L2 - http://dx.doi.org/10.1097/MPG.0b013e31824703c7 DB - PRIME DP - Unbound Medicine ER -