Accuracy of a no-biopsy approach for the diagnosis of coeliac disease across different adult cohorts
| Autor: | David Rowlands, Julio C. Bai, Gabrio Bassotti, Lauren Marks, Mihai Danciu, Hugo A Penny, Hamid Mohaghegh Shalmani, Adam Levene, Kamran Rostami, Benjamin Lebwohl, Umberto Volta, Arzu Ensari, Antonio Carroccio, Roxana Maxim, S Ishaq, Vincenzo Villanacci, Simon S. Cross, G. Wild, Michelle S Lau, Mohammad H. Derakhshan, Elisabeth Mr Baggus, Irene Alexandra Spiridon, Mohammad Rostami-Nejad, David S Sanders, Hetty J. Bontkes, Amitabh Srivastava, Peter H.R. Green, Matt W Johnson, Suneil A Raju, Azita Ganji |
|---|---|
| Přispěvatelé: | Penny H.A., Raju S.A., Lau M.S., Marks L.J.S., Baggus E.M.R., Bai J.C., Bassotti G., Bontkes H.J., Carroccio A., Danciu M., Derakhshan M.H., Ensari A., Ganji A., Green P.H.R., Johnson M.W., Ishaq S., Lebwohl B., Levene A., Maxim R., Mohaghegh Shalmani H., Rostami-Nejad M., Rowlands D., Spiridon I.A., Srivastava A., Volta U., Villanacci V., Wild G., Cross S.S., Rostami K., Sanders D.S. |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Tissue transglutaminase Serum iga Gastroenterology Sensitivity and Specificity Coeliac disease Endoscopy Gastrointestinal Diagnosis Differential Predictive Value of Tests Internal medicine Biopsy Medicine Humans Transglutaminases biology medicine.diagnostic_test business.industry Histology Middle Aged medicine.disease Upper GI endoscopy United Kingdom Immunoglobulin A Titer Celiac Disease Cohort biology.protein business Biomarkers coeliac disease |
| Zdroj: | Gut |
| ISSN: | 0017-5749 |
| Popis: | ObjectiveWe aimed to determine the predictive capacity and diagnostic yield of a 10-fold increase in serum IgA antitissue transglutaminase (tTG) antibody levels for detecting small intestinal injury diagnostic of coeliac disease (CD) in adult patients.DesignThe study comprised three adult cohorts. Cohort 1: 740 patients assessed in the specialist CD clinic at a UK centre; cohort 2: 532 patients with low suspicion for CD referred for upper GI endoscopy at a UK centre; cohort 3: 145 patients with raised tTG titres from multiple international sites. Marsh 3 histology was used as a reference standard against which we determined the performance characteristics of an IgA tTG titre of ≥10×ULN for a diagnosis of CD.ResultsCohort 1: the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for IgA tTG levels of ≥10×ULN at identifying individuals with Marsh 3 lesions were 54.0%, 90.0%, 98.7% and 12.5%, respectively. Cohort 2: the sensitivity, specificity, PPV and NPV for IgA tTG levels of ≥10×ULN at identifying individuals with Marsh 3 lesions were 50.0%, 100.0%, 100.0% and 98.3%, respectively. Cohort 3: the sensitivity, specificity, PPV and NPV for IgA tTG levels of ≥10×ULN at identifying individuals with Marsh 3 lesions were 30.0%, 83.0%, 95.2% and 9.5%, respectively.ConclusionOur results show that IgA tTG titres of ≥10×ULN have a strong predictive value at identifying adults with intestinal changes diagnostic of CD. This study supports the use of a no-biopsy approach for the diagnosis of adult CD. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|