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 ...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 against human tissue transglutaminase was 10%(95%confidence interval 1%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 against human tissue transglutaminase was 10%(95%confidence interval 1%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.
