A Brazilian experience of the self transglutaminase-based test for celiac disease case finding and diet monitoring

AIM:To evaluate the effectiveness of a rapid and easy fingertip whole blood point-of-care test for celiac disease(CD)case finding and diet monitoring. METHODS:Three hundred individuals,206 females (68.7%)and 94 males(31.3%),were submitted to a rapid and easy immunoglobulin-A-class fingertip whole blood point-of-care test in the doctor’s office in order to make immediate clinical decisions:13 healthy controls, 6 with CD suspicion,46 treated celiacs,84 relatives of the celiac patients,69 patients with dyspepsia,64 with irritable bowel syndrome(IBS),8 with Crohn’s disease and 9 with other causes of diarrhea. RESULTS:Upper gastrointestinal endoscopy with duodenal biopsies was performed in patients with CD suspicion and in individuals with positive test outcome: in 83.3%(5/6)of the patients with CD suspicion,in 100%of the patients that admitted gluten-free diet transgressions(6/6),in 3.8%of first-degree relatives (3/79)and in 2.9%of patients with dyspepsia(2/69). In all these individuals duodenal biopsies confirmed CD(Marsh’s histological classification).The studied test showed good correlation with serologic antibodies, endoscopic and histological findings.CONCLUSION:The point-of-care test was as reliable as conventional serological tests in detecting CD cases and in CD diet monitoring.