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

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dc.contributor.author Ylonen, Venla
dc.contributor.author Lindfors, Katri
dc.contributor.author Repo, Marleena
dc.contributor.author Huhtala, Heini
dc.contributor.author Fuchs, Valma
dc.contributor.author Saavalainen, Päivi
dc.contributor.author Musikka, Alex
dc.contributor.author Laurila, Kaija
dc.contributor.author Kaukinen, Katri
dc.contributor.author Kurppa, Kalle
dc.date.accessioned 2020-11-05T13:01:01Z
dc.date.available 2020-11-05T13:01:01Z
dc.date.issued 2020-09
dc.identifier.citation 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
dc.identifier.other PURE: 150525757
dc.identifier.other PURE UUID: fe0df5c7-e1d7-42cb-8a0f-3f247c9d66c9
dc.identifier.other WOS: 000580210400001
dc.identifier.uri http://hdl.handle.net/10138/321135
dc.description.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. en
dc.format.extent 9
dc.language.iso eng
dc.relation.ispartof Nutrients
dc.rights cc_by
dc.rights.uri info:eu-repo/semantics/openAccess
dc.subject celiac disease
dc.subject anti-transglutaminase 2 antibodies
dc.subject serology
dc.subject screening
dc.subject adults
dc.subject TISSUE TRANSGLUTAMINASE LEVELS
dc.subject SMALL-BOWEL
dc.subject VILLOUS ATROPHY
dc.subject MILD ENTEROPATHY
dc.subject HIGH-RISK
dc.subject ANTIBODIES
dc.subject GUIDELINES
dc.subject CHILDREN
dc.subject CRITERIA
dc.subject GLUTEN
dc.subject 3143 Nutrition
dc.title Non-Biopsy Serology-Based Diagnosis of Celiac Disease in Adults Is Accurate with Different Commercial Kits and Pre-Test Probabilities en
dc.type Article
dc.contributor.organization Immunomics
dc.contributor.organization Research Programs Unit
dc.contributor.organization Department of Medical and Clinical Genetics
dc.contributor.organization TRIMM - Translational Immunology Research Program
dc.contributor.organization University of Helsinki
dc.description.reviewstatus Peer reviewed
dc.relation.doi https://doi.org/10.3390/nu12092736
dc.relation.issn 2072-6643
dc.rights.accesslevel openAccess
dc.type.version publishedVersion

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