Omitting duodenal biopsy in children with suspected celiac disease and extra-intestinal symptoms
| Autor: | Sara Pagani, Chiara Gertosio, Carmine Tinelli, Giovanni Farello, Lorenzo Iughetti, Mauro Bozzola, Valeria Calcaterra, Ombretta Luinetti, Daniela Larizza, Cristina Meazza |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Pediatrics Adolescent Genotype Biopsy Enzyme-Linked Immunosorbent Assay Disease Polymerase Chain Reaction Gastroenterology 03 medical and health sciences 0302 clinical medicine Anti-endomysial antibodies Anti-transglutaminase antibodies Celiac disease Children HLA genotype Celiac Disease Child Duodenal Diseases Female Humans Italy Retrospective Studies 030225 pediatrics Internal medicine Medicine Pediatric gastroenterology biology medicine.diagnostic_test business.industry Research Triple test lcsh:RJ1-570 lcsh:Pediatrics Retrospective cohort study Hepatology biology.protein 030211 gastroenterology & hepatology business |
| Zdroj: | Italian Journal of Pediatrics Italian Journal of Pediatrics, Vol 43, Iss 1, Pp 1-5 (2017) |
| ISSN: | 1824-7288 |
| DOI: | 10.1186/s13052-017-0377-5 |
| Popis: | Background The aim of our study is to evaluate if in children with highly positive serology and HLA-DQ2/DQ8 (triple test, TT) and only extra-intestinal symptoms, it is possible to omit performing an intestinal biopsy for celiac disease (CD) diagnosis, as suggested by the new European Society for Pediatric Gastroenterology, Hepatology and Nutrition ESPGHAN guidelines. Methods In this retrospective study a total of 105 patients, suspected of having CD because of extra-intestinal symptoms and showing serum tissue transglutaminase antibody (anti-tTG) and anti-endomysial antibody (EMA) measurements and HLA genotyping, were considered for the final analysis (33 boys and 72 girls; age range 1.5–17.6 years). Results Histological findings confirmed diagnosis of CD in 97 (92.4%) patients. Forty-one patients (39%) showed anti-tTG >10 times normal values, positive EMA and positive HLA-DQ2/DQ8 (positive TT). All of them had a diagnosis of CD, therefore there were no false positive cases. Sixty-four patients were negative for the TT. In eight cases, CD was ruled out and these were considered true negative cases. In the remaining 56 negative TT patients, intestinal biopsy confirmed CD diagnosis and they were considered false negatives. Based on these results, specificity for the TT was 100% and sensitivity was 42.3%. Conclusions On the basis of the present study, diagnosis of CD can be reliably performed without a duodenal biopsy in children with only extra-intestinal symptoms. |
| Databáze: | OpenAIRE |
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