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Determination of IgG and IgA antibodies against native gliadin is not helpful for the diagnosis of coeliac disease in children up to 2 years old.
J Pediatr Gastroenterol Nutr. 2012 Jul; 55(1):21-5.JP

Abstract

OBJECTIVE

Assays for antibodies against native gliadin (anti-nGli) are still often assumed to perform better in the diagnosis of coeliac disease in young children than tests for antibodies to deamidated gliadin (anti-dGli), tissue transglutaminase (anti-tTG), and endomysium (EmA). We compared the performance of assays for anti-nGli, anti-dGli, anti-tTG, and EmA in this age group.

METHODS

We investigated retrospectively 184 children (42 with coeliac disease under normal diet and 142 controls) up to 2 years of age. Immunoglobulin (Ig) A- and IgG-anti-dGli, IgA- and IgG-anti-nGli, IgA- and IgG-anti-tTG, and IgA-EmA were measured in serum. Areas under receiver operating characteristics curves, sensitivities, specificities, positive and negative predictive values, positive and negative likelihood ratios, as well as diagnostic odds ratios were calculated.

RESULTS

From all of the tests investigated, only assays for IgG-anti-dGli, IgA-anti-tTG, and IgA-EmA had high specificity (≥ 0.96) connected with high sensitivity (≥ 0.86), with high positive predictive values (≥ 0.52 and ≥ 0.69 at pretest probabilities of 0.05 and 0.1, respectively) and negative predictive values (≥ 0.99 and ≥ 0.98 at pretest probabilities of 0.05 and 0.1, respectively). These assays also showed high positive likelihood ratio (≥ 24) at low negative likelihood ratio (≤ 0.15) and high diagnostic odds ratios (≥ 136).

CONCLUSIONS

Our results do not support the use of assays of anti-nGli to diagnose coeliac disease in young children. IgA-anti-tTG, IgA-EmA, and IgG-anti-dGli perform better than anti-nGli.

Authors+Show Affiliations

Children's Hospital of the Clinical Centre, Sankt Georg, Leipzig, Germany.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 available

Pub Type(s)

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

Language

eng

PubMed ID

22249805

Citation

Richter, Thomas, et al. "Determination of IgG and IgA Antibodies Against Native Gliadin Is Not Helpful for the Diagnosis of Coeliac Disease in Children Up to 2 Years Old." Journal of Pediatric Gastroenterology and Nutrition, vol. 55, no. 1, 2012, pp. 21-5.
Richter T, Bossuyt X, Vermeersch P, et al. Determination of IgG and IgA antibodies against native gliadin is not helpful for the diagnosis of coeliac disease in children up to 2 years old. J Pediatr Gastroenterol Nutr. 2012;55(1):21-5.
Richter, T., Bossuyt, X., Vermeersch, P., Uhlig, H. H., Stern, M., Hauer, A., Zimmer, K. P., Mearin, L., de Roo, J. H., Dähnrich, C., & Mothes, T. (2012). Determination of IgG and IgA antibodies against native gliadin is not helpful for the diagnosis of coeliac disease in children up to 2 years old. Journal of Pediatric Gastroenterology and Nutrition, 55(1), 21-5. https://doi.org/10.1097/MPG.0b013e31824678fc
Richter T, et al. Determination of IgG and IgA Antibodies Against Native Gliadin Is Not Helpful for the Diagnosis of Coeliac Disease in Children Up to 2 Years Old. J Pediatr Gastroenterol Nutr. 2012;55(1):21-5. PubMed PMID: 22249805.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Determination of IgG and IgA antibodies against native gliadin is not helpful for the diagnosis of coeliac disease in children up to 2 years old. AU - Richter,Thomas, AU - Bossuyt,Xavier, AU - Vermeersch,Pieter, AU - Uhlig,Holm H, AU - Stern,Martin, AU - Hauer,Almuthe, AU - Zimmer,Klaus-Peter, AU - Mearin,Luisa, AU - de Roo,Johanna Hendrika Clementina, AU - Dähnrich,Cornelia, AU - Mothes,Thomas, PY - 2012/1/18/entrez PY - 2012/1/18/pubmed PY - 2012/12/10/medline SP - 21 EP - 5 JF - Journal of pediatric gastroenterology and nutrition JO - J Pediatr Gastroenterol Nutr VL - 55 IS - 1 N2 - OBJECTIVE: Assays for antibodies against native gliadin (anti-nGli) are still often assumed to perform better in the diagnosis of coeliac disease in young children than tests for antibodies to deamidated gliadin (anti-dGli), tissue transglutaminase (anti-tTG), and endomysium (EmA). We compared the performance of assays for anti-nGli, anti-dGli, anti-tTG, and EmA in this age group. METHODS: We investigated retrospectively 184 children (42 with coeliac disease under normal diet and 142 controls) up to 2 years of age. Immunoglobulin (Ig) A- and IgG-anti-dGli, IgA- and IgG-anti-nGli, IgA- and IgG-anti-tTG, and IgA-EmA were measured in serum. Areas under receiver operating characteristics curves, sensitivities, specificities, positive and negative predictive values, positive and negative likelihood ratios, as well as diagnostic odds ratios were calculated. RESULTS: From all of the tests investigated, only assays for IgG-anti-dGli, IgA-anti-tTG, and IgA-EmA had high specificity (≥ 0.96) connected with high sensitivity (≥ 0.86), with high positive predictive values (≥ 0.52 and ≥ 0.69 at pretest probabilities of 0.05 and 0.1, respectively) and negative predictive values (≥ 0.99 and ≥ 0.98 at pretest probabilities of 0.05 and 0.1, respectively). These assays also showed high positive likelihood ratio (≥ 24) at low negative likelihood ratio (≤ 0.15) and high diagnostic odds ratios (≥ 136). CONCLUSIONS: Our results do not support the use of assays of anti-nGli to diagnose coeliac disease in young children. IgA-anti-tTG, IgA-EmA, and IgG-anti-dGli perform better than anti-nGli. SN - 1536-4801 UR - https://www.unboundmedicine.com/medline/citation/22249805/Determination_of_IgG_and_IgA_antibodies_against_native_gliadin_is_not_helpful_for_the_diagnosis_of_coeliac_disease_in_children_up_to_2_years_old_ L2 - https://doi.org/10.1097/MPG.0b013e31824678fc DB - PRIME DP - Unbound Medicine ER -