Non-Biopsy Serology-Based Diagnosis of Celiac Disease in Adults is Accurate with Different Commercial Kits and Pre-Test Probabilities
Non-biopsy diagnosis of celiac disease is possible in children with anti-transglutaminase 2 antibodies (TGA) > 10× the upper limit of normal (ULN) and positive anti-endomysial antibodies (EMA). Similar criteria have been suggested for adults, but evidence with different TGA assays is scarce. We c...
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doaj-cc6a5d419bcd448ab0ab9f9919aa89c12020-11-25T02:53:02ZengMDPI AGNutrients2072-66432020-09-01122736273610.3390/nu12092736Non-Biopsy Serology-Based Diagnosis of Celiac Disease in Adults is Accurate with Different Commercial Kits and Pre-Test ProbabilitiesVenla Ylönen0Katri Lindfors1Marleena Repo2Heini Huhtala3Valma Fuchs4Päivi Saavalainen5Alex Musikka6Kaija Laurila7Katri Kaukinen8Kalle Kurppa9Celiac Disease Research Centre, Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, FinlandCeliac Disease Research Centre, Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, FinlandCeliac Disease Research Centre, Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, FinlandFaculty of Social Sciences, Tampere University, 33520 Tampere, FinlandCeliac Disease Research Centre, Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, FinlandResearch Programs Unit, Immunobiology, and Haartman Institute, Department of Medical Genetics, University of Helsinki, 00014 Helsinki, FinlandCeliac Disease Research Centre, Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, FinlandTampere Center for Child Health Research, Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, FinlandCeliac Disease Research Centre, Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, FinlandTampere Center for Child Health Research, Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, FinlandNon-biopsy diagnosis of celiac disease is possible in children with anti-transglutaminase 2 antibodies (TGA) > 10× the upper limit of normal (ULN) and positive anti-endomysial antibodies (EMA). Similar criteria have been suggested for adults, but evidence with different TGA assays is scarce. We compared the performance of four TGA tests in the diagnosis of celiac disease in cohorts with diverse pre-test probabilities. Serum samples from 836 adults with either clinical suspicion or family risk of celiac disease were tested with four commercial TGA assays, EmA and celiac disease-associated genetics. The diagnosis was set based on duodenal lesion or, in some cases, using special methods. 137 (57%) patients with clinical suspicion and 85 (14%) of those with family risk had celiac disease. Positive predictive value (PPV) for 10×ULN was 100% in each TGA test. The first non-diagnostic investigations were encountered with ULN 1.0×–5.1× in the clinical cohort and 1.3×–4.9× in the family cohort, respectively. Using the assays’ own cut-offs (1×ULN) the PPVs ranged 84–100%. Serology-based diagnosis of celiac disease was accurate in adults using different commercial kits and pre-test probabilities using 10×ULN. The results also suggest that the ULN threshold for biopsy-omitting approach could be lower<b>.</b>https://www.mdpi.com/2072-6643/12/9/2736celiac diseaseanti-transglutaminase 2 antibodiesserologyscreeningadults |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Venla Ylönen Katri Lindfors Marleena Repo Heini Huhtala Valma Fuchs Päivi Saavalainen Alex Musikka Kaija Laurila Katri Kaukinen Kalle Kurppa |
spellingShingle |
Venla Ylönen Katri Lindfors Marleena Repo Heini Huhtala Valma Fuchs Päivi Saavalainen Alex Musikka Kaija Laurila Katri Kaukinen Kalle Kurppa Non-Biopsy Serology-Based Diagnosis of Celiac Disease in Adults is Accurate with Different Commercial Kits and Pre-Test Probabilities Nutrients celiac disease anti-transglutaminase 2 antibodies serology screening adults |
author_facet |
Venla Ylönen Katri Lindfors Marleena Repo Heini Huhtala Valma Fuchs Päivi Saavalainen Alex Musikka Kaija Laurila Katri Kaukinen Kalle Kurppa |
author_sort |
Venla Ylönen |
title |
Non-Biopsy Serology-Based Diagnosis of Celiac Disease in Adults is Accurate with Different Commercial Kits and Pre-Test Probabilities |
title_short |
Non-Biopsy Serology-Based Diagnosis of Celiac Disease in Adults is Accurate with Different Commercial Kits and Pre-Test Probabilities |
title_full |
Non-Biopsy Serology-Based Diagnosis of Celiac Disease in Adults is Accurate with Different Commercial Kits and Pre-Test Probabilities |
title_fullStr |
Non-Biopsy Serology-Based Diagnosis of Celiac Disease in Adults is Accurate with Different Commercial Kits and Pre-Test Probabilities |
title_full_unstemmed |
Non-Biopsy Serology-Based Diagnosis of Celiac Disease in Adults is Accurate with Different Commercial Kits and Pre-Test Probabilities |
title_sort |
non-biopsy serology-based diagnosis of celiac disease in adults is accurate with different commercial kits and pre-test probabilities |
publisher |
MDPI AG |
series |
Nutrients |
issn |
2072-6643 |
publishDate |
2020-09-01 |
description |
Non-biopsy diagnosis of celiac disease is possible in children with anti-transglutaminase 2 antibodies (TGA) > 10× the upper limit of normal (ULN) and positive anti-endomysial antibodies (EMA). Similar criteria have been suggested for adults, but evidence with different TGA assays is scarce. We compared the performance of four TGA tests in the diagnosis of celiac disease in cohorts with diverse pre-test probabilities. Serum samples from 836 adults with either clinical suspicion or family risk of celiac disease were tested with four commercial TGA assays, EmA and celiac disease-associated genetics. The diagnosis was set based on duodenal lesion or, in some cases, using special methods. 137 (57%) patients with clinical suspicion and 85 (14%) of those with family risk had celiac disease. Positive predictive value (PPV) for 10×ULN was 100% in each TGA test. The first non-diagnostic investigations were encountered with ULN 1.0×–5.1× in the clinical cohort and 1.3×–4.9× in the family cohort, respectively. Using the assays’ own cut-offs (1×ULN) the PPVs ranged 84–100%. Serology-based diagnosis of celiac disease was accurate in adults using different commercial kits and pre-test probabilities using 10×ULN. The results also suggest that the ULN threshold for biopsy-omitting approach could be lower<b>.</b> |
topic |
celiac disease anti-transglutaminase 2 antibodies serology screening adults |
url |
https://www.mdpi.com/2072-6643/12/9/2736 |
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