Tags

Type your tag names separated by a space and hit enter

High prevalence of silent celiac disease in preschool children screened with IgA/IgG antiendomysium antibodies.
J Pediatr Gastroenterol Nutr 1999; 28(1):26-30JP

Abstract

BACKGROUND

Because of the different sensitivity and specificity of serologic tests, the search for silent celiac disease is usually performed with the combined or sequential use of several tests. Among these, the IgA-class endomysium antibody test has the highest specificity and positive predictive value, but it may overlook IgA-deficient patients.

METHODS

To test a new one-step screening approach, serum samples from 427 apparently healthy, 3- to 6-year-old Hungarian children were investigated for IgA-class and IgG-class endomysium antibodies using monkey esophagus and human jejunum as substrates.

RESULTS

Five new cases with flat mucosa were identified by strong endomysium antibody positivity and subsequent jejunal biopsy, yielding a celiac disease prevalence of 1:85. An additional child may have latent celiac disease (slight histologic changes at present). Two of the screening-detected celiac patients exhibited only IgG-class endomysium antibodies due to associated IgA-deficiency. Despite the young age of the screened population, antigliadin antibodies were positive in only three of the five celiac patients.

CONCLUSIONS

Prevalence of celiac disease in the study population was much higher than expected on the basis of antigliadin antibody-based studies. The screening system used detected celiac cases in which there was IgA-deficiency and those in which there was not and also those negative for antigliadin antibodies. The findings suggest the importance of the primary testing of autoantibodies in future celiac disease screening policies.

Authors+Show Affiliations

Department of Gastroenterology-Nephrology, Heim Pál Children's Hospital, Budapest, Hungary.No 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

9890464

Citation

Korponay-Szabó, I R., et al. "High Prevalence of Silent Celiac Disease in Preschool Children Screened With IgA/IgG Antiendomysium Antibodies." Journal of Pediatric Gastroenterology and Nutrition, vol. 28, no. 1, 1999, pp. 26-30.
Korponay-Szabó IR, Kovács JB, Czinner A, et al. High prevalence of silent celiac disease in preschool children screened with IgA/IgG antiendomysium antibodies. J Pediatr Gastroenterol Nutr. 1999;28(1):26-30.
Korponay-Szabó, I. R., Kovács, J. B., Czinner, A., Gorácz, G., Vámos, A., & Szabó, T. (1999). High prevalence of silent celiac disease in preschool children screened with IgA/IgG antiendomysium antibodies. Journal of Pediatric Gastroenterology and Nutrition, 28(1), pp. 26-30.
Korponay-Szabó IR, et al. High Prevalence of Silent Celiac Disease in Preschool Children Screened With IgA/IgG Antiendomysium Antibodies. J Pediatr Gastroenterol Nutr. 1999;28(1):26-30. PubMed PMID: 9890464.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High prevalence of silent celiac disease in preschool children screened with IgA/IgG antiendomysium antibodies. AU - Korponay-Szabó,I R, AU - Kovács,J B, AU - Czinner,A, AU - Gorácz,G, AU - Vámos,A, AU - Szabó,T, PY - 1999/1/16/pubmed PY - 1999/1/16/medline PY - 1999/1/16/entrez SP - 26 EP - 30 JF - Journal of pediatric gastroenterology and nutrition JO - J. Pediatr. Gastroenterol. Nutr. VL - 28 IS - 1 N2 - BACKGROUND: Because of the different sensitivity and specificity of serologic tests, the search for silent celiac disease is usually performed with the combined or sequential use of several tests. Among these, the IgA-class endomysium antibody test has the highest specificity and positive predictive value, but it may overlook IgA-deficient patients. METHODS: To test a new one-step screening approach, serum samples from 427 apparently healthy, 3- to 6-year-old Hungarian children were investigated for IgA-class and IgG-class endomysium antibodies using monkey esophagus and human jejunum as substrates. RESULTS: Five new cases with flat mucosa were identified by strong endomysium antibody positivity and subsequent jejunal biopsy, yielding a celiac disease prevalence of 1:85. An additional child may have latent celiac disease (slight histologic changes at present). Two of the screening-detected celiac patients exhibited only IgG-class endomysium antibodies due to associated IgA-deficiency. Despite the young age of the screened population, antigliadin antibodies were positive in only three of the five celiac patients. CONCLUSIONS: Prevalence of celiac disease in the study population was much higher than expected on the basis of antigliadin antibody-based studies. The screening system used detected celiac cases in which there was IgA-deficiency and those in which there was not and also those negative for antigliadin antibodies. The findings suggest the importance of the primary testing of autoantibodies in future celiac disease screening policies. SN - 0277-2116 UR - https://www.unboundmedicine.com/medline/citation/9890464/High_prevalence_of_silent_celiac_disease_in_preschool_children_screened_with_IgA/IgG_antiendomysium_antibodies_ L2 - http://dx.doi.org/10.1097/00005176-199901000-00008 DB - PRIME DP - Unbound Medicine ER -