IgA Deficiency Is Not Systematically Ruled Out in Patients Undergoing Celiac Disease Testing
| Autor: | Belen Duarte, Juan S. Lasa, Diego Berardi, Silvina Paz, Ezequiel Nazario, Ignacio Zubiaurre, Alexis Muryan, Amalia Schill |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Immunoglobulin A medicine.medical_specialty Abdominal pain Physiology Gastroenterology Serology 03 medical and health sciences 0302 clinical medicine Diabetes mellitus Internal medicine Humans Medicine Family history Autoantibodies Transglutaminases biology business.industry IgA Deficiency Hepatology medicine.disease Celiac Disease Diarrhea 030220 oncology & carcinogenesis biology.protein 030211 gastroenterology & hepatology medicine.symptom business Body mass index |
| Zdroj: | Digestive Diseases and Sciences. 67:1238-1243 |
| ISSN: | 1573-2568 0163-2116 |
| Popis: | Guidelines for celiac disease (CD) testing recommend total serum IgA determination alongside anti-transglutaminase IgA antibodies. It is not well known if lack of serum IgA determination is a common finding in clinical practice. To determine the prevalence of lack of serum IgA determination among patients screened for celiac disease. We identified all subjects who underwent serum anti-transglutaminase IgA and/or other CD-related antibodies determination at a single teaching hospital in Buenos Aires from October 2019 to February 2020. Medical records were reviewed to select adult patients who were tested for celiac disease. The primary outcome was the proportion of patients with inadequate testing for celiac disease due to lack of serum IgA determination. We retrieved the following variables from each patient’s record: age, gender, body mass index, symptoms present at screening, first-grade family history of CD, history of type-1 diabetes mellitus, autoimmune hypothyroidism, Down’s syndrome. Overall, 1122 patients were included for analysis. Lack of serum IgA determination prevalence was 20.49%. Among patients who did have serum IgA determination, the prevalence of IgA deficiency was 5.16%. The following variables were independently associated with a significantly increased odds of serum IgA determination: diarrhea [OR 1.55 (1.01–2.34)] and abdominal pain [OR 2.28 (1.44–3.63)]; higher body mass index [OR 0.91 (0.85–0.98)], osteoporosis [OR 0.49 (0.28–0.89)], hypothyroidism [OR 0.18 (0.07–0.45)], arthralgia/arthritis [OR 0.47 (0.27–0.85)], or testing by endocrinologist [OR 0.46 (0.23–0.91)] and gynecologist [OR 0.14 (0.06–0.31)] were inversely associated. IgA deficiency is not systematically ruled out in a relatively high proportion of patients undergoing serological screening of celiac disease. |
| Databáze: | OpenAIRE |
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