Diagnostic Value of Immunoglobulin G Anti-Deamidated Gliadin Peptide Antibody for Diagnosis of Pediatric Celiac Disease: A Study from Shiraz, Iran.

IF 1.3 Q3 PEDIATRICS
Mohammad Hossein Anbardar, Fatemeh Golbon Haghighi, Naser Honar, Mozhgan Zahmatkeshan
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引用次数: 1

Abstract

Purpose: Screening serologic tests are important tools for the diagnosis of celiac disease (CD). Immunoglobulin (Ig)G anti-deamidated gliadin peptide (anti-DGP) is a relatively new autoantibody thought to have good diagnostic accuracy, comparable to that of anti-tissue transglutaminase (anti-tTG) antibody.

Methods: Pediatric patients (n=86) with a clinical suspicion of CD were included. Duodenal biopsy, anti-tTG, and IgG anti-DGP antibody tests were performed. The patients were divided into CD and control groups based on the pathological evaluation of duodenal biopsies. The diagnostic accuracy of serological tests was determined.

Results: IgA anti-tTG and IgG anti-DGP antibodies were positive in 86.3% and 95.4% of patients, respectively. The sensitivity, specificity, and diagnostic accuracy of the IgA anti-tTG test were 86.3%, 50.0%, and 68.6%, respectively, and those of the IgG anti-DGP test were 95.4%, 85.7%, and 90.7%, respectively. The area under the receiver operating characteristic (ROC) curve was 0.84 (95% confidence interval [CI], 0.74-0.91) for IgA anti-tTG test and 0.93 (95% CI, 0.86-0.97) for IgG anti-DGP test. The comparison of IgA anti-tTG and IgG anti-DGP ROC curves showed a higher sensitivity and specificity of the IgG anti-DGP test.

Conclusion: IgG anti-DGP is a reliable serological test for CD diagnosis in children. High tTG and DGP titers in the serum are suggestive of severe duodenal atrophy. The combined use of IgA anti-tTG and IgG anti-DGP tests for the initial screening of CD can improve diagnostic sensitivity.

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免疫球蛋白G抗脱酰胺麦胶蛋白肽抗体对小儿乳糜泻的诊断价值:伊朗设拉子地区的研究
目的:筛查血清学检查是诊断乳糜泻(CD)的重要工具。免疫球蛋白(Ig)G抗脱酰胺麦胶蛋白肽(anti-DGP)是一种相对较新的自身抗体,被认为具有良好的诊断准确性,与抗组织转谷氨酰胺酶(anti-tTG)抗体相当。方法:纳入临床怀疑为乳糜泻的儿童患者(n=86)。进行十二指肠活检、抗ttg和IgG抗dgp抗体检测。根据十二指肠活检病理结果分为CD组和对照组。测定血清学试验的诊断准确性。结果:IgA抗ttg抗体阳性率为86.3%,IgG抗dgp抗体阳性率为95.4%。IgA抗ttg检测的敏感性、特异性和诊断准确率分别为86.3%、50.0%和68.6%,IgG抗dgp检测的敏感性、特异性和诊断准确率分别为95.4%、85.7%和90.7%。IgA抗ttg试验受试者工作特征(ROC)曲线下面积为0.84(95%可信区间[CI], 0.74 ~ 0.91), IgG抗dgp试验受试者工作特征(ROC)曲线下面积为0.93(95%可信区间[CI], 0.86 ~ 0.97)。IgA抗ttg和IgG抗dgp的ROC曲线比较显示,IgG抗dgp检测具有更高的敏感性和特异性。结论:IgG抗dgp是诊断儿童CD的可靠血清学指标。血清中tTG和DGP滴度高提示严重的十二指肠萎缩。联合应用IgA抗ttg和IgG抗dgp试验对CD进行初步筛查,可提高诊断敏感性。
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来源期刊
CiteScore
3.90
自引率
0.00%
发文量
43
期刊介绍: Pediatric Gastroenterology, Hepatology and Nutrition (Pediatr Gastroenterol Hepatol Nutr), an official journal of The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition, is issued bimonthly and published in English. The aim of Pediatr Gastroenterol Hepatol Nutr is to advance scientific knowledge and promote child healthcare by publishing high-quality empirical and theoretical studies and providing a recently updated knowledge to those practitioners and scholars in the field of pediatric gastroenterology, hepatology and nutrition. Pediatr Gastroenterol Hepatol Nutr publishes review articles, original articles, and case reports. All of the submitted papers are peer-reviewed. The journal covers basic and clinical researches on molecular and cellular biology, pathophysiology, epidemiology, diagnosis, and treatment of all aspects of pediatric gastrointestinal diseases and nutritional health problems.
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