Evaluation of antibodies against deaminated gliadin peptides in children under two years of age with negative anti-tissue transglutaminase antibodies
Celiac disease is an immune-mediated disorder caused by gluten, characterized by the presence of clinical manifestations, specific antibodies, HLA-DQ2 or HLA-DQ8 haplotypes, and enteropathy. Specific antibodies include those directed against tissue transglutaminase: tTG (a-tTG); those directed again...
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| Autores principales: | , , , , , , , |
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| Formato: | Artículo revista |
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Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2022
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| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/39058 |
| Aporte de: |
| Sumario: | Celiac disease is an immune-mediated disorder caused by gluten, characterized by the presence of clinical manifestations, specific antibodies, HLA-DQ2 or HLA-DQ8 haplotypes, and enteropathy. Specific antibodies include those directed against tissue transglutaminase: tTG (a-tTG); those directed against deaminated gliadin peptides (a-DGP) and anti-endomysium antibodies (EMA). The determination of specific antibodies must always be accompanied by the measurement of serum immunoglobulin A. If it is higher than 20 mg/dL, IgA isotype antibodies should be investigated, and if not, the IgG isotype. a-DGPs show lower performance compared to the other two antibodies. However, its use is suggested as an additional test, especially in children under 2 years of age when IgA a-tTG screening is negative. Objective: To evaluate the serological concordance between IgA a-DGP and EMA, considered the reference serological technique, in children under two years of age with negative IgA a-tTG.
Retrospective descriptive observational work. 123 patients under 2 years of age with serum IgA greater than 20 mg/dL and negative IgA a-tTG were given IgA-DGP and EMA. The statistical programs "InfoStat" free version and "MedCalc" version 10.2.0.0 were used. To assess the concordance of a-DGP with EMA, the Kappa index was used.
A concordance K index of 0.08 (95% CI -0.211; 0.364) was obtained between IgA a-DGP and EMA, the degree of agreement is insignificant.
The insignificant concordance between IgA a-DGP and EMA supports that the combination of tests (IgA a-tTG and IgA a-DGP) does not provide advantages in the diagnosis of celiac disease. The results of this work have a direct impact on the daily work of the immunology laboratory. The economic resources and the delivery time of the results will be optimized by modifying the diagnostic algorithm, with the performance of IgA a-tTG as the only screening test. |
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