Celiac Disease Research Today is a free monthly online journal that collates and summarizes the latest research about Celiac Disease, including details on symptoms, diagnosis, causes, diet. | ||||||||
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Detection of secretory IgA antibodies against gliadin and human tissue transglutaminase in stool to screen for coeliac disease in children: validation study.Kappler M, Krauss-Etschmann S, Diehl V, Zeilhofer H, Koletzko S Division of Gastroenterology, Dr. v. Haunersches Kinderspital, Ludwig Maximilians University, 80337 Munich, Germany. OBJECTIVE: To evaluate two commercial stool tests for detection of secretory IgA antibodies against gliadin and human tissue transglutaminase for diagnosis of coeliac disease in children with symptoms. SETTING: Tertiary care children's hospital. PARTICIPANTS: Coded stool samples from 20 children with newly diagnosed coeliac disease and 64 controls. Six children with coeliac disease had stool tests every two weeks for three months after starting a gluten-free diet. MAIN OUTCOME MEASURES: Secretory IgA antibodies against gliadin and human tissue transglutaminase in stool samples, determined in duplicate by using recommended cut-off limits. RESULTS: Sensitivity of faecal antibodies against human tissue transglutaminase was 10% (95% confidence interval 1% to 32%), and specificity was 98% (91% to 100%). For antibodies against gliadin, sensitivity was 6% (0% to 29%) and specificity was 97% (89% to 100%). Optimisation of cut-off limits by receiver operating characteristic analysis and use of results of both tests increased sensitivity to 82%, but specificity decreased to 58%. All follow-up stool tests remained negative, except for two positive anti-gliadin results in one patient, six and 10 weeks after the gluten-free diet was started. CONCLUSIONS: Neither stool test was suitable for screening for coeliac disease in children with symptoms. Published 27 January 2006 in BMJ, 332(7535): 213-4.
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