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
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.
