BACKGROUND: Different serologic tests are available for the diagnosis of celiac disease (CD). AIM: To evaluate the diagnostic performance of anti-tissue transglutaminase (tTG) and anti-deamidated gliadin (DGP) for the serologic diagnosis of CD. METHODS: The study population consisted of 107 consecutive adult CD and 542 consecutive disease controls who underwent an intestinal biopsy. Samples were tested for total IgA, IgA anti-tTG, and IgG anti-DGP antibodies using assays from 2 manufacturers (INOVA and Thermo Fisher). Samples were also tested by a screening assay that simultaneously detects IgA and IgG antibodies to tTG and DGP (tTG/DGP screen) (INOVA). RESULTS: Positivity for anti-DGP or anti-tTG had a likelihood ratio for CD that varied between 20 and 115, depending on the assay. Double positivity (positive for anti-tTG and anti-DGP) had the highest likelihood ratio (≥ 215) for CD. The likelihood ratios for single positivity (positivity for one assay combined with negativity for the other) had a likelihood ratio between 0.8 and 10.1. The likelihood ratio for CD was lowest (≤ 0.12) for double negative test results. Decision tree analysis revealed that determining IgA anti-tTG and IgG anti-DGP in all patients performed better than other serologic strategies. CONCLUSIONS: The use of likelihood ratios improves the clinical interpretation of serologic testing for CD. Double positive test results had the highest likelihood ratio for CD, whereas double negative test results had the lowest likelihood ratio.
BACKGROUND: Different serologic tests are available for the diagnosis of celiac disease (CD). AIM: To evaluate the diagnostic performance of anti-tissue transglutaminase (tTG) and anti-deamidated gliadin (DGP) for the serologic diagnosis of CD. METHODS: The study population consisted of 107 consecutive adult CD and 542 consecutive disease controls who underwent an intestinal biopsy. Samples were tested for total IgA, IgA anti-tTG, and IgG anti-DGP antibodies using assays from 2 manufacturers (INOVA and Thermo Fisher). Samples were also tested by a screening assay that simultaneously detects IgA and IgG antibodies to tTG and DGP (tTG/DGP screen) (INOVA). RESULTS: Positivity for anti-DGP or anti-tTG had a likelihood ratio for CD that varied between 20 and 115, depending on the assay. Double positivity (positive for anti-tTG and anti-DGP) had the highest likelihood ratio (≥ 215) for CD. The likelihood ratios for single positivity (positivity for one assay combined with negativity for the other) had a likelihood ratio between 0.8 and 10.1. The likelihood ratio for CD was lowest (≤ 0.12) for double negative test results. Decision tree analysis revealed that determining IgA anti-tTG and IgG anti-DGP in all patients performed better than other serologic strategies. CONCLUSIONS: The use of likelihood ratios improves the clinical interpretation of serologic testing for CD. Double positive test results had the highest likelihood ratio for CD, whereas double negative test results had the lowest likelihood ratio.
Authors: Bradley N Spatola; Joseph A Murray; Martin Kagnoff; Katri Kaukinen; Patrick S Daugherty Journal: Anal Chem Date: 2012-12-21 Impact factor: 6.986
Authors: Nicholas A Hoerter; Sarah E Shannahan; Jorge Suarez; Suzanne K Lewis; Peter H R Green; Daniel A Leffler; Benjamin Lebwohl Journal: Dig Dis Sci Date: 2017-02-04 Impact factor: 3.199
Authors: Isabel A Hujoel; Claire L Jansson-Knodell; Philippe P Hujoel; Margaux L A Hujoel; Rok Seon Choung; Joseph A Murray; Alberto Rubio-Tapia Journal: J Clin Gastroenterol Date: 2021-04-01 Impact factor: 3.174
Authors: Gabriella Lakos; Gary L Norman; Michael Mahler; Peter Martis; Chelsea Bentow; Debby Santora; Alessio Fasano Journal: J Immunol Res Date: 2014-03-13 Impact factor: 4.818
Authors: Rachele Ciccocioppo; Peter Kruzliak; Giuseppina C Cangemi; Miroslav Pohanka; Elena Betti; Eugenia Lauret; Luis Rodrigo Journal: Nutrients Date: 2015-10-22 Impact factor: 5.717