KMID : 1038820210240020218
|
|
Pediatric Gastroenterology, Hepatology & Nutrition 2021 Volume.24 No. 2 p.218 ~ p.229
|
|
Influence of Age and Type 1 Diabetes Mellitus on Serological Test for Celiac Disease in Children
|
|
Maheshwari Anshu
He Zhaoping Weidner Melissa Nicole Lin Patrick Bober Ryan Del Rosario Fernando J.
|
|
Abstract
|
|
|
Purpose: Serological tests of tissue transglutaminase (TTG) and deamidated gliadin (DGP) antibodies for celiac disease diagnosis show conflicting correlation with histology in young children and in type 1 diabetes mellitus (T1DM). Tests' ability to predict histology and cutoff values based on age and T1DM was evaluated.
Methods: A retrospective study of children who had celiac serological tests between 6/1/2002 and 12/31/2014 at a pediatric hospital.
Results: TTG IgA displayed similar results in predicting histology between <4.0 and ¡Ã4.0 years age groups with sensitivity 98% and 93%, and specificity 88% and 86%, respectively. In children <4.0 years old, sensitivity for DGP antibodies was 100% and specificity 94%; in ¡Ã4.0 years age groups, sensitivity was 60%, 88% for DGP IgA and IgG and specificity 95%, 96%, respectively. TTG IgA had low specificity in patients with T1DM compared with non-T1DM, 42% vs. 91%. Positive TTG IgA with normal histology was associated with higher T1DM prevalence at 36% compared with negative tests at 4%. Finally, the TTG IgA cutoff value was higher in T1DM at 36 vs. 16.3 units in non-T1DM. DGP IgG cutoff showed similar values between age groups; TTG IgA and DGP IgA cutoffs were lower in <4.0 years at 8.3 and 11.9 units than ¡Ã4.0 years at 23.4 and 19.9, respectively.
Conclusion: TTG IgA is sufficient for the <4.0 years age group and DGP antibodies had no advantage over TTG IgA in older children. The cutoff value to determine a positive TTG IgA should be higher for children with T1DM.
|
|
KEYWORD
|
|
Celiac disease, Serologic tests, Child, Type 1 diabetes mellitus
|
|
FullTexts / Linksout information
|
|
|
|
Listed journal information
|
|
|
|