Title: Combining antibody tests and taking into account antibody levels improves serologic diagnosis of celiac disease
Authors: Oyaert, Matthijs ×
Vermeersch, Pieter
De Hertogh, Gert
Hiele, Martin
Vandeputte, Nathalie
Hoffman, Ilse
Bossuyt, Xavier #
Issue Date: Sep-2015
Publisher: Walter de Gruyter
Series Title: Clinical Chemistry and Laboratory Medicine vol:53 issue:10 pages:1537-46
Article number: 10.1515/cclm-2013-1099
Abstract: Abstract Background: The European Society for Pediatric Gastroenterology and Nutrition states that if IgA anti-tissue transglutaminase (tTG) exceeds 10 times the upper limit of normal (ULN), there is the possibility to diagnose celiac disease (CD) without duodenal biopsy, if supported by anti-endomysium testing and human leukocyte antigen (HLA) typing. We aimed to evaluate whether combining IgA tTG and IgG anti-deamidated gliadin peptide (DGP) antibody testing and taking into account the antibody levels improves clinical interpretation. Methods: We calculated likelihood ratios for various test result combinations using data obtained from newly diagnosed CD patients (n=156) [13 children <2 years, 45 children between 2 and 16 years, and 98 adults (>16 years)] and 974 disease controls. All patients and controls underwent duodenal biopsy. IgA anti-tTG and IgG anti-DGP assays were from Thermo Fisher and Inova. Results: Likelihood ratios for CD markedly increased with double positivity and increasing antibody levels of IgA anti-tTG and IgG anti-DGP. Patients with double positivity and high antibody levels (>3 times, >10 times ULN) had a high probability for having CD (likelihood ratio ≥649 for >3 times ULN and ∞ for >10 times ULN). The fraction of CD patients with double positivity and high antibody levels was 59%-67% (depending on the assay) for >3 ULN and 33%-36% (depending on the assay) for >10 ULN, respectively. This fraction was significantly higher in children with CD than in adults. Conclusions: Combining IgG anti-DGP with IgA anti-tTG and defining thresholds for antibody levels improves the serologic diagnosis of CD.
ISSN: 1434-6621
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Laboratory of Clinical Bacteriology and Mycology
Translational Cell & Tissue Research
Translational Research in GastroIntestinal Disorders
Organ Systems (+)
Experimental Laboratory Immunology
× corresponding author
# (joint) last author

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