Diagnostic Utility of Modified Gliadin Peptide Antibody Assays in New Zealand Children

Ben Hope; Rohan Ameratunga; Paul M. Austin; Helen M. Evans; Jeannette MacFarlane; Stephen Mouat; Simon E. Chin

doi:10.1097/MPG.0b013e31828b382d

Diagnostic Utility of Modified Gliadin Peptide Antibody Assays in New Zealand Children

Ben Hope
, Rohan Ameratunga
, Paul M. Austin
, Helen M. Evans
, Jeannette MacFarlane
, Stephen Mouat
, Simon E. Chin^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

7 Citations (Scopus)

Abstract

Objective: The aim of the present study was to evaluate a panel of different antibody assays, including second-generation antigliadin kits, in a local paediatric population thought to be at risk for coeliac disease (CD).

Methods: Seventy-nine children, who tested positive for immunoglobulin A (IgA) antibodies to tissue transglutaminase (TG), underwent duodenal biopsy. At endoscopy, serum was collected from all of the patients, and 9 different coeliac antibody assays were performed, both as isolated assays and in combination. These included immunoglobulin A (IgA) anti-tissue transglutaminase (TGA), and IgA plus IgG anti-deamidated gliadin peptide (DGPAG). A diagnosis of CD was made if the biopsies showed Marsh grade 3 lesions.

Results: Twenty-four of 79 children had CD confirmed histologically. Only 39 of 79 were positive for Inova TGA, and 35 of 79 were positive for Inova DGPAG. Twenty-four of 39 who were TGA positive and 24 of 35 who were DGPAG positive had confirmed CD on biopsy. There was good correlation between TGA and DGPAG-positive predictive values. None of the modified gliadin tests produced false-negative results, and neither did the TGA.

Conclusions: The Inova DGPAG and TGA assays have similar use in predicting CD in a selected paediatric population; however, in children who are positive for TGA when screened for CD, more than half have negative TGA serology when repeat testing is done at the time of biopsy. Those with persistent TGA positivity have only a 61.5% probability of having histologic CD, compared with 68.6% of those children positive for DGPAG.

Original language	English
Pages (from-to)	43-48
Number of pages	6
Journal	Journal of Pediatric Gastroenterology and Nutrition
Volume	57
Issue number	1
DOIs	https://doi.org/10.1097/MPG.0b013e31828b382d
Publication status	Published - Jul 2013

Keywords

coeliac disease
children
deamidated gliadin peptide
modified gliadin peptide
serology
tissue transglutaminase antibody
CHILDHOOD CELIAC-DISEASE
DEAMIDATED GLIADIN
NATURAL-HISTORY
TISSUE TRANSGLUTAMINASE
CLINICAL PRESENTATION
IMMUNOGLOBULIN-A
ACCURACY
MARKERS
RECOGNITION
SENSITIVITY

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10.1097/MPG.0b013e31828b382d

Cite this

@article{c77855aa11f943618dabd03709bad71f,

title = "Diagnostic Utility of Modified Gliadin Peptide Antibody Assays in New Zealand Children",

abstract = "Objective: The aim of the present study was to evaluate a panel of different antibody assays, including second-generation antigliadin kits, in a local paediatric population thought to be at risk for coeliac disease (CD). Methods: Seventy-nine children, who tested positive for immunoglobulin A (IgA) antibodies to tissue transglutaminase (TG), underwent duodenal biopsy. At endoscopy, serum was collected from all of the patients, and 9 different coeliac antibody assays were performed, both as isolated assays and in combination. These included immunoglobulin A (IgA) anti-tissue transglutaminase (TGA), and IgA plus IgG anti-deamidated gliadin peptide (DGPAG). A diagnosis of CD was made if the biopsies showed Marsh grade 3 lesions. Results: Twenty-four of 79 children had CD confirmed histologically. Only 39 of 79 were positive for Inova TGA, and 35 of 79 were positive for Inova DGPAG. Twenty-four of 39 who were TGA positive and 24 of 35 who were DGPAG positive had confirmed CD on biopsy. There was good correlation between TGA and DGPAG-positive predictive values. None of the modified gliadin tests produced false-negative results, and neither did the TGA. Conclusions: The Inova DGPAG and TGA assays have similar use in predicting CD in a selected paediatric population; however, in children who are positive for TGA when screened for CD, more than half have negative TGA serology when repeat testing is done at the time of biopsy. Those with persistent TGA positivity have only a 61.5\% probability of having histologic CD, compared with 68.6\% of those children positive for DGPAG.",

keywords = "coeliac disease, children, deamidated gliadin peptide, modified gliadin peptide, serology, tissue transglutaminase antibody, CHILDHOOD CELIAC-DISEASE, DEAMIDATED GLIADIN, NATURAL-HISTORY, TISSUE TRANSGLUTAMINASE, CLINICAL PRESENTATION, IMMUNOGLOBULIN-A, ACCURACY, MARKERS, RECOGNITION, SENSITIVITY",

author = "Ben Hope and Rohan Ameratunga and Austin, \{Paul M.\} and Evans, \{Helen M.\} and Jeannette MacFarlane and Stephen Mouat and Chin, \{Simon E.\}",

year = "2013",

month = jul,

doi = "10.1097/MPG.0b013e31828b382d",

language = "English",

volume = "57",

pages = "43--48",

journal = "Journal of Pediatric Gastroenterology and Nutrition",

issn = "0277-2116",

publisher = "Lippincott Williams and Wilkins",

number = "1",

}

TY - JOUR

T1 - Diagnostic Utility of Modified Gliadin Peptide Antibody Assays in New Zealand Children

AU - Hope, Ben

AU - Ameratunga, Rohan

AU - Austin, Paul M.

AU - Evans, Helen M.

AU - MacFarlane, Jeannette

AU - Mouat, Stephen

AU - Chin, Simon E.

PY - 2013/7

Y1 - 2013/7

N2 - Objective: The aim of the present study was to evaluate a panel of different antibody assays, including second-generation antigliadin kits, in a local paediatric population thought to be at risk for coeliac disease (CD). Methods: Seventy-nine children, who tested positive for immunoglobulin A (IgA) antibodies to tissue transglutaminase (TG), underwent duodenal biopsy. At endoscopy, serum was collected from all of the patients, and 9 different coeliac antibody assays were performed, both as isolated assays and in combination. These included immunoglobulin A (IgA) anti-tissue transglutaminase (TGA), and IgA plus IgG anti-deamidated gliadin peptide (DGPAG). A diagnosis of CD was made if the biopsies showed Marsh grade 3 lesions. Results: Twenty-four of 79 children had CD confirmed histologically. Only 39 of 79 were positive for Inova TGA, and 35 of 79 were positive for Inova DGPAG. Twenty-four of 39 who were TGA positive and 24 of 35 who were DGPAG positive had confirmed CD on biopsy. There was good correlation between TGA and DGPAG-positive predictive values. None of the modified gliadin tests produced false-negative results, and neither did the TGA. Conclusions: The Inova DGPAG and TGA assays have similar use in predicting CD in a selected paediatric population; however, in children who are positive for TGA when screened for CD, more than half have negative TGA serology when repeat testing is done at the time of biopsy. Those with persistent TGA positivity have only a 61.5% probability of having histologic CD, compared with 68.6% of those children positive for DGPAG.

AB - Objective: The aim of the present study was to evaluate a panel of different antibody assays, including second-generation antigliadin kits, in a local paediatric population thought to be at risk for coeliac disease (CD). Methods: Seventy-nine children, who tested positive for immunoglobulin A (IgA) antibodies to tissue transglutaminase (TG), underwent duodenal biopsy. At endoscopy, serum was collected from all of the patients, and 9 different coeliac antibody assays were performed, both as isolated assays and in combination. These included immunoglobulin A (IgA) anti-tissue transglutaminase (TGA), and IgA plus IgG anti-deamidated gliadin peptide (DGPAG). A diagnosis of CD was made if the biopsies showed Marsh grade 3 lesions. Results: Twenty-four of 79 children had CD confirmed histologically. Only 39 of 79 were positive for Inova TGA, and 35 of 79 were positive for Inova DGPAG. Twenty-four of 39 who were TGA positive and 24 of 35 who were DGPAG positive had confirmed CD on biopsy. There was good correlation between TGA and DGPAG-positive predictive values. None of the modified gliadin tests produced false-negative results, and neither did the TGA. Conclusions: The Inova DGPAG and TGA assays have similar use in predicting CD in a selected paediatric population; however, in children who are positive for TGA when screened for CD, more than half have negative TGA serology when repeat testing is done at the time of biopsy. Those with persistent TGA positivity have only a 61.5% probability of having histologic CD, compared with 68.6% of those children positive for DGPAG.

KW - coeliac disease

KW - children

KW - deamidated gliadin peptide

KW - modified gliadin peptide

KW - serology

KW - tissue transglutaminase antibody

KW - CHILDHOOD CELIAC-DISEASE

KW - DEAMIDATED GLIADIN

KW - NATURAL-HISTORY

KW - TISSUE TRANSGLUTAMINASE

KW - CLINICAL PRESENTATION

KW - IMMUNOGLOBULIN-A

KW - ACCURACY

KW - MARKERS

KW - RECOGNITION

KW - SENSITIVITY

U2 - 10.1097/MPG.0b013e31828b382d

DO - 10.1097/MPG.0b013e31828b382d

M3 - Article

SN - 0277-2116

VL - 57

SP - 43

EP - 48

JO - Journal of Pediatric Gastroenterology and Nutrition

JF - Journal of Pediatric Gastroenterology and Nutrition

IS - 1

ER -

Diagnostic Utility of Modified Gliadin Peptide Antibody Assays in New Zealand Children

Abstract

Keywords

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