AI Article Synopsis
- The study aimed to evaluate the effectiveness of deamidated gliadin peptide (DGP) tests in diagnosing celiac disease (CD) in comparison to tissue-transglutaminase-IgA (TTG-IgA) tests.
- Involving children who were tested for CD from 2012 to 2019, the research compared two groups: children with symptoms and asymptomatic high-risk children, finding that DGP-IgG test results showed comparable sensitivity and predictive values to TTG-IgA.
- The findings concluded that while DGP-IgG tests did not significantly enhance the TTG-IgA test's performance, higher DGP-IgG levels correlated with intestinal damage, confirming that TTG-IgA
Article Abstract
Objectives: Use of deamidated gliadin peptide (DGP) test kits as adjunctive to tissue-transglutaminase-IgA (TTG-IgA) for the diagnosis of celiac disease (CD) has been a controversial issue. The objectives of our study were to evaluate the diagnostic performance of DGP antibodies compared with TTG-IgA and to evaluate the correlation between DGP-antibody titers and degree of enteropathy.
Methods: We included children who underwent endoscopy and biopsies because of positivity of any of the serology tests in the "celiac profile" (TTG-IgA, DGP-IgA, and DGP-IgG) from 2012 to 2019. We divided children into clinically suspected cases of CD (group 1) and asymptomatic cases screened as they were from a high-risk group (group 2).
Results: Group 1 constituted 52 children and group 2 included 81 children (76 type-1 diabetes [T1D]). The sensitivity and positive-predictive value (PPV) of DGP-IgG in group 1 (90%, 98%) and group 2 (91%, 85.5%) were comparable with TTG-IgA (98%, 92% in group 1; 100%, 80% in group 2). By adding DGP-IgG to TTG-IgA, the performance of TTG-IgA has improved marginally in group 1 (sensitivity 100%, PPV 92.3%). All cases with DGP-IgG titer 2 times ULN in group 1, and >4 times ULN in group 2 had villous atrophy. All T1D patients with TTG IgA >10 times ULN had villous atrophy.
Conclusions: DGP-IgG assay did not add to the performance of TTG-IgA. DGP-IgG titer correlated with enteropathy. The diagnosis of CD can be made in asymptomatic T1D child with TTG-IgA titer >10 times ULN and positive endomyseal antibodies.
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| http://dx.doi.org/10.1097/MPG.0000000000003022 | DOI Listing |
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