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Celiac Disease Screening by Immunochromatographic Visual Assays: Results of a Multicenter Study

2007; Lippincott Williams & Wilkins; Volume: 45; Issue: 5 Linguagem: Inglês

10.1097/mpg.0b013e31814794b9

1536-4801

Luis Carlos Blesa Baviera, Ester Donat, Luís Ortigosa, Néstor Litwin, Luis Peña Quintana, Virginia Méndez, Ma Victoria González, J. Manzanares López-Manzanares, Enrique Méndez, Carmen Ribes‐Koninckx,

Microscopic Colitis

ABSTRACT Objective: To assay the efficiency for celiac disease (CD) screening of 2 immunochromatographic visual stick assays based on human recombinant tissue transglutaminase (tTG). One was the antitissue transglutaminase antibodies (AtTGA) stick for IgA/G antibodies to tTG detection, the other was the AtTGA/antigliadin antibodies (AGA) stick for IgA antibodies for tTG and/or gliadins. Patients and Methods: In a prospective multicenter study, 4 pediatric gastroenterology units from Spain and 2 from Latin America enrolled 72 control children with a normal small bowel mucosa and 113 untreated patients with CD with Marsh type 3 lesions. Results: Evaluation of results by the gastroenterologists and by 2 independent observers at the coordination center showed a remarkably low interobserver variability. For the AtTGA stick, sensitivity was 96.5% and specificity was 98.6%. The AtTGA/AGA stick displayed a sensitivity of 94.5% and a specificity of 98.6% for AtTGA and a sensitivity of 63.1% and a specificity of 95.2% for AGA. The highest efficiency and positive likelihood ratio was obtained for the AtTGA stick, higher than for IgA AtTGA by enzyme‐linked immunosorbent assay. One additional advantage was that previous investigation of total serum IgA levels could be eluded. The IgA AtTGA/AGA stick, with an efficiency of 95.1%, compared with 89.2% when the combined results of the 2 enzyme‐linked immunosorbent assays were considered, turned out to be an excellent diagnostic tool for infants with no IgA deficiency. Conclusion: These 2 assays are extremely efficient for CD screening, by combining a high diagnostic accuracy with the simplicity and rapidity of visual methods.