Objective: To evaluate two commercial stool tests for detection of secretory IgA antibodies against gliadin and human tissue transglutaminase for diagnosis of coeliac disease in children with symptoms. Setting: Tertia...Objective: To evaluate two commercial stool tests for detection of secretory IgA antibodies against gliadin and human tissue transglutaminase for diagnosis of coeliac disease in children with symptoms. Setting: Tertiary care children’s hospital. Participants: Coded stool samples from 20 children with newly diagnosed coeliac disease and 64 controls. Six children with coeliac disease had stool tests every two weeks for three months after starting a gluten-free diet. Main outcome measures: Secretory IgA antibodies against gliadin and human tissue transglutaminase in stool samples, determined in duplicate by using recommended cut-off limits. Results: Sensitivity of faecal antibodies a-gainst human tissue transglutaminase was 10% (95% confidence interval l%to 32% ), and specificity was 98% (91% to 100% ). For antibodies against gliadin, sensitivity was 6% (0% to 29% ) and specificity was 97% (89% to 100% ). Optimisation of cut-off limits by receiver operating characteristic analysis and use of results of both tests increased sensitivity to 82% , but specificity decreased to 58%. All follow-up stool tests remained negative, except for two positive anti-gliadin results in one patient, six and 10 weeks after the gluten-free diet was started. Conclusions: Neither stool test was suitable for screening for coeliac disease in children with symptoms.展开更多
Celiac disease (CD) is a disease having the characteristic pathology of the mu cosa of the small intestine. The prevalence of CD in the Turkish population has not been investigated previously. The present study was de...Celiac disease (CD) is a disease having the characteristic pathology of the mu cosa of the small intestine. The prevalence of CD in the Turkish population has not been investigated previously. The present study was designed to determine th e prevalence of CD in healthy blood donors. Serum samples of 2000 healthy blood donors presenting to Hacettepe University Faculty of Medicine Hospital Blood Ban k were tested for tissue transglutaminase (tTG) IgA and IgG antibodies with enzy me-linked immunosorbent assay (ELISA; Euroimmune, Germany). The histopathologic al findings for the cases with positive serology were evaluated. The distributio n of sex was 95.7%male, and 4.3%female. The mean age was 33±9. Among 2000 don ors, 23 (1.15%) were positive for tTG IgA antibody and 3 (0.15%) were positive for tTG IgG antibody. None of the samples was positive for both antibodies. Ser um total IgA was measured in two cases with only tTG IgG positivity and was foun d to be low in one case. Twelve subjects positive for tTG agreed to endoscopy an d biopsy. Histopathological examination revealed changes classified as Marsh III -II in one,Marsh II in two, Marsh I in seven, and Marsh 0 in two donors. This w as the first study conducted to determine the prevalence of tTG positivity in th e Turkish population. The tTG antibody positivity prevalence in healthy blood do nors was as high as 1.3%. This study shows that the prevalence of CD in the Tur kish population is relatively high in comparison to that in the Western world.展开更多
文摘Objective: To evaluate two commercial stool tests for detection of secretory IgA antibodies against gliadin and human tissue transglutaminase for diagnosis of coeliac disease in children with symptoms. Setting: Tertiary care children’s hospital. Participants: Coded stool samples from 20 children with newly diagnosed coeliac disease and 64 controls. Six children with coeliac disease had stool tests every two weeks for three months after starting a gluten-free diet. Main outcome measures: Secretory IgA antibodies against gliadin and human tissue transglutaminase in stool samples, determined in duplicate by using recommended cut-off limits. Results: Sensitivity of faecal antibodies a-gainst human tissue transglutaminase was 10% (95% confidence interval l%to 32% ), and specificity was 98% (91% to 100% ). For antibodies against gliadin, sensitivity was 6% (0% to 29% ) and specificity was 97% (89% to 100% ). Optimisation of cut-off limits by receiver operating characteristic analysis and use of results of both tests increased sensitivity to 82% , but specificity decreased to 58%. All follow-up stool tests remained negative, except for two positive anti-gliadin results in one patient, six and 10 weeks after the gluten-free diet was started. Conclusions: Neither stool test was suitable for screening for coeliac disease in children with symptoms.
文摘Celiac disease (CD) is a disease having the characteristic pathology of the mu cosa of the small intestine. The prevalence of CD in the Turkish population has not been investigated previously. The present study was designed to determine th e prevalence of CD in healthy blood donors. Serum samples of 2000 healthy blood donors presenting to Hacettepe University Faculty of Medicine Hospital Blood Ban k were tested for tissue transglutaminase (tTG) IgA and IgG antibodies with enzy me-linked immunosorbent assay (ELISA; Euroimmune, Germany). The histopathologic al findings for the cases with positive serology were evaluated. The distributio n of sex was 95.7%male, and 4.3%female. The mean age was 33±9. Among 2000 don ors, 23 (1.15%) were positive for tTG IgA antibody and 3 (0.15%) were positive for tTG IgG antibody. None of the samples was positive for both antibodies. Ser um total IgA was measured in two cases with only tTG IgG positivity and was foun d to be low in one case. Twelve subjects positive for tTG agreed to endoscopy an d biopsy. Histopathological examination revealed changes classified as Marsh III -II in one,Marsh II in two, Marsh I in seven, and Marsh 0 in two donors. This w as the first study conducted to determine the prevalence of tTG positivity in th e Turkish population. The tTG antibody positivity prevalence in healthy blood do nors was as high as 1.3%. This study shows that the prevalence of CD in the Tur kish population is relatively high in comparison to that in the Western world.
