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BMJ. 2006 Jan 28;332(7535):213-4. Epub 2005 Dec 23.

Detection of secretory IgA antibodies against gliadin and human tissue transglutaminase in stool to screen for coeliac disease in children: validation study.

Author information

  • 1Division of Gastroenterology, Dr. v. Haunersches Kinderspital, Ludwig Maximilians University, 80337 Munich, Germany.

Abstract

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.

PMID:
16377644
[PubMed - indexed for MEDLINE]
PMCID:
PMC1352053
Free PMC Article
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