INTRODUCTION: The Autoimmunity Screening for Kids (ASK) study is a large scale pediatric screening study in Colorado for celiac disease (CD) and type 1 diabetes. This is a report of the CD outcomes for the first 9,973 children screened through ASK. METHODS: ASK screens children aged 1-17 years for CD using 2 highly sensitive assays for tissue transglutaminase autoantibodies (TGA): a radiobinding (RBA) assay for IgA TGA and an electrochemiluminescence (ECL) assay that detects all TGA isotypes. Children who test positive on either assay are asked to return for confirmatory testing. Those with a confirmed RBA TGA level ≥ 0.1 (twice the upper limit of normal) are referred to the Colorado Center for Celiac Disease for further evaluation; all others are referred to primary care. RESULTS: Of the initial 9,973 children screened, 242 children were TGA+ by any assay. Of those initially positive, 185 children (76.4%) have completed a confirmation blood draw with 149 children (80.5%) confirming positive by RBA TGA. Confirmed RBA TGA+ was associated with a family history of CD (odds ratio [OR] = 1.83; 95% confidence interval 1.06-3.16), non-Hispanic white ethnicity (OR = 3.34; 2.32-4.79), and female sex (OR = 1.43; 1.03-1.98). Gastrointestinal symptoms of CD, assessed at the initial screening, were reported equally often among the RBA TGA+ vs TGA- children (32.1% vs 30.5%, P = 0.65). DISCUSSION: The initial results of this ongoing mass-screening program confirm a high prevalence of undiagnosed CD autoimmunity in a screened US population. Symptoms at initial screening were not associated with TGA status (see Visual abstract, Supplementary Digital Content 5, http://links.lww.com/AJG/B587).
INTRODUCTION: The Autoimmunity Screening for Kids (ASK) study is a large scale pediatric screening study in Colorado for celiac disease (CD) and type 1 diabetes. This is a report of the CD outcomes for the first 9,973 children screened through ASK. METHODS: ASK screens children aged 1-17 years for CD using 2 highly sensitive assays for tissue transglutaminase autoantibodies (TGA): a radiobinding (RBA) assay for IgA TGA and an electrochemiluminescence (ECL) assay that detects all TGA isotypes. Children who test positive on either assay are asked to return for confirmatory testing. Those with a confirmed RBA TGA level ≥ 0.1 (twice the upper limit of normal) are referred to the Colorado Center for Celiac Disease for further evaluation; all others are referred to primary care. RESULTS: Of the initial 9,973 children screened, 242 children were TGA+ by any assay. Of those initially positive, 185 children (76.4%) have completed a confirmation blood draw with 149 children (80.5%) confirming positive by RBA TGA. Confirmed RBA TGA+ was associated with a family history of CD (odds ratio [OR] = 1.83; 95% confidence interval 1.06-3.16), non-Hispanic white ethnicity (OR = 3.34; 2.32-4.79), and female sex (OR = 1.43; 1.03-1.98). Gastrointestinal symptoms of CD, assessed at the initial screening, were reported equally often among the RBA TGA+ vs TGA- children (32.1% vs 30.5%, P = 0.65). DISCUSSION: The initial results of this ongoing mass-screening program confirm a high prevalence of undiagnosed CD autoimmunity in a screened US population. Symptoms at initial screening were not associated with TGA status (see Visual abstract, Supplementary Digital Content 5, http://links.lww.com/AJG/B587).
Authors: Kirsi Mustalahti; Carlo Catassi; Antti Reunanen; Elisabetta Fabiani; Margit Heier; Stan McMillan; Liam Murray; Marie-Helene Metzger; Maurizio Gasparin; Enzo Bravi; Markku Mäki Journal: Ann Med Date: 2010-12 Impact factor: 4.709
Authors: Ellen J van Koppen; Joachim J Schweizer; Cassandra G D S Csizmadia; Yvonne Krom; Herbertien B Hylkema; Annemarie M van Geel; Hendrik M Koopman; S Pauline Verloove-Vanhorick; Maria Luisa Mearin Journal: Pediatrics Date: 2009-04 Impact factor: 7.124
Authors: Marcella Li; Liping Yu; Claudio Tiberti; Margherita Bonamico; Iman Taki; Dongmei Miao; Joseph A Murray; Marian J Rewers; Edward J Hoffenberg; Daniel Agardh; Patricia Mueller; Martin Stern; Ezio Bonifacio; Edwin Liu Journal: Am J Gastroenterol Date: 2009-01 Impact factor: 10.864
Authors: Markku Mäki; Kirsi Mustalahti; Jorma Kokkonen; Petri Kulmala; Mila Haapalahti; Tuomo Karttunen; Jorma Ilonen; Kaija Laurila; Ingrid Dahlbom; Tony Hansson; Peter Höpfl; Mikael Knip Journal: N Engl J Med Date: 2003-06-19 Impact factor: 91.245
Authors: Michelle A E Jansen; Jessica C Kiefte-de Jong; Romy Gaillard; Johanna C Escher; Albert Hofman; Vincent W V Jaddoe; Herbert Hooijkaas; Henriette A Moll Journal: Clin Gastroenterol Hepatol Date: 2014-09-22 Impact factor: 11.382
Authors: M Ines Pinto-Sanchez; Jocelyn A Silvester; Benjamin Lebwohl; Daniel A Leffler; Robert P Anderson; Amelie Therrien; Ciaran P Kelly; Elena F Verdu Journal: Nat Rev Gastroenterol Hepatol Date: 2021-09-15 Impact factor: 46.802