¿Son válidos los criterios ESPGHAN con el método de quimioluminiscencia? Análisis de los posibles errores en el diagnóstico de la enfermedad celiaca

IF 1.5 4区医学 Q2 PEDIATRICS

Anales de pediatria Pub Date : 2025-03-01 DOI:10.1016/j.anpedi.2024.503742

Rocío Garcés Cubel , Ruth García Romero , Ignacio Ros Arnal , Yolanda González Irazabal , Guillermo Hernández de Abajo

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Abstract

Objectives

To determine how many patients may have received a mistaken diagnosis of coeliac disease using the ESPGHAN 2012 and 2020 criteria without performance of biopsy when using chemiluminescence, and to evaluate possible causes of interference affecting anti-tissue transglutaminase antibody results obtained with this technique.

Methods

Retrospective and descriptive study of biopsies of patients with elevated tissue transglutaminase antibodies (tTGA) measured by chemiluminescence in a tertiary care hospital.

Results

The sample included 135 patients with a mean age of 7.7 years. The diagnosis of coeliac disease was confirmed in 67 (49.6%) and ruled out in the remaining 68 (50.4%).

Subsequently, among those with a non-diagnostic biopsy, we found that 13 (19.1%) would have met the ESPGHAN 2012 criteria and 17 (25%) the ESPGHAN 2020 criteria. The tTG antibody levels were greater than 10 times the upper limit of normal (ULN) in 27.9%. In patients who tested positive for endomysial antibodies (EMA), the cut-off point for tTGA measured by chemiluminescence that achieved the best combined sensitivity and specificity (Youden index) was 849 U/mL (42.5 × ULN).

Conclusions

Transglutaminase antibody levels measured by chemiluminescence offer a high sensitivity, but there can be artifacts due to situations such as infection by H. pylori. Therefore, the ESPGHAN guidelines must be revised for application in this particular case.

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来源期刊

Anales de pediatria 医学-小儿科

CiteScore

2.10

自引率

4.80%

发文量

155

审稿时长

44 days

期刊介绍： La Asociación Española de Pediatría tiene como uno de sus objetivos principales la difusión de información científica rigurosa y actualizada sobre las distintas áreas de la pediatría. Anales de Pediatría es el Órgano de Expresión Científica de la Asociación y constituye el vehículo a través del cual se comunican los asociados. Publica trabajos originales sobre investigación clínica en pediatría procedentes de España y países latinoamericanos, así como artículos de revisión elaborados por los mejores profesionales de cada especialidad, las comunicaciones del congreso anual y los libros de actas de la Asociación, y guías de actuación elaboradas por las diferentes Sociedades/Secciones Especializadas integradas en la Asociación Española de Pediatría.