Non-Biopsy Serology-Based Diagnosis of Celiac Disease in Adults Is Accurate with Different Commercial Kits and Pre-Test Probabilities

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Ylonen , V , Lindfors , K , Repo , M , Huhtala , H , Fuchs , V , Saavalainen , P , Musikka , A , Laurila , K , Kaukinen , K & Kurppa , K 2020 , ' Non-Biopsy Serology-Based Diagnosis of Celiac Disease in Adults Is Accurate with Different Commercial Kits and Pre-Test Probabilities ' , Nutrients , vol. 12 , no. 9 , 2736 . https://doi.org/10.3390/nu12092736

Title: Non-Biopsy Serology-Based Diagnosis of Celiac Disease in Adults Is Accurate with Different Commercial Kits and Pre-Test Probabilities
Author: Ylonen, Venla; Lindfors, Katri; Repo, Marleena; Huhtala, Heini; Fuchs, Valma; Saavalainen, Päivi; Musikka, Alex; Laurila, Kaija; Kaukinen, Katri; Kurppa, Kalle
Other contributor: University of Helsinki, Immunomics




Date: 2020-09
Language: eng
Number of pages: 9
Belongs to series: Nutrients
ISSN: 2072-6643
DOI: https://doi.org/10.3390/nu12092736
URI: http://hdl.handle.net/10138/321135
Abstract: Non-biopsy diagnosis of celiac disease is possible in children with anti-transglutaminase 2 antibodies (TGA) > 10x the upper limit of normal (ULN) and positive anti-endomysial antibodies (EMA). Similar criteria have been suggested for adults, but evidence with different TGA assays is scarce. We compared the performance of four TGA tests in the diagnosis of celiac disease in cohorts with diverse pre-test probabilities. Serum samples from 836 adults with either clinical suspicion or family risk of celiac disease were tested with four commercial TGA assays, EmA and celiac disease-associated genetics. The diagnosis was set based on duodenal lesion or, in some cases, using special methods. 137 (57%) patients with clinical suspicion and 85 (14%) of those with family risk had celiac disease. Positive predictive value (PPV) for 10xULN was 100% in each TGA test. The first non-diagnostic investigations were encountered with ULN 1.0x-5.1x in the clinical cohort and 1.3x-4.9x in the family cohort, respectively. Using the assays' own cut-offs (1xULN) the PPVs ranged 84-100%. Serology-based diagnosis of celiac disease was accurate in adults using different commercial kits and pre-test probabilities using 10xULN. The results also suggest that the ULN threshold for biopsy-omitting approach could be lower.
Subject: celiac disease
anti-transglutaminase 2 antibodies
serology
screening
adults
TISSUE TRANSGLUTAMINASE LEVELS
SMALL-BOWEL
VILLOUS ATROPHY
MILD ENTEROPATHY
HIGH-RISK
ANTIBODIES
GUIDELINES
CHILDREN
CRITERIA
GLUTEN
3143 Nutrition
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