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  • Jefferson Adams
    Jefferson Adams

    Saliva Screening for Anti-transglutaminase Autoantibody Effective for Diagnosing Celiac Disease in Children

    Reviewed and edited by a celiac disease expert.

    Caption: New celiac saliva screening study in JPGN.

    Celiac.com 12/13/2010 - Driven by the high prevalence of celiac disease, a team of researchers based in Italy to assess a new, noninvasive disease screening strategy that would allow them to make an early diagnosis of celiac disease in 6- to 8-year-old children.

    Timely diagnosis will help doctors to initiate a gluten-free diet in willing patients, achieve growth targets, and prevent celiac disease complications.

    For the study, the research team recruited 5000 subjects, and ultimately tested 4048 saliva samples for anti-tissue transglutaminase (tTG) and immunoglobulin (Ig)A using fluid-phase radioimmunoprecipitation.

    For children with positive samples, the team arranged follow-up screening by serum radioimmunoassay tTG IgA, enzyme-linked immunosorbent assay tTG IgA, and anti-endomysium IgA. Children with positive serum assays underwent endoscopy with duodenal biopsies, and researchers advised those diagnosed with celiac disease to start a gluten-free diet.

    The team gained screening consent from 4242 parents (84.8%), and obtained usable saliva samples from a total of 4048 children (95.4%). Thirty-two children showed positive salivary tTG IgA, with another nine showing borderline autoantibody results.

    Thirty-one of the 32 tTG IgA-positive subjects, and three of the nine borderline subjects also had positive blood screens. Intestinal biopsy showed twenty-eight children with villous atrophy, while one child showed Marsh 1 lesions. The research team recommended a gluten-free diet to three children without performing endoscopy.

    This makes for a celiac disease rate of 1.16% in the study population, including 19 known cases of celiac disease.

    The results show that screening detected three cases of celiac disease for every two cases diagnosed before screening was 3:2. The ratio between symptomatic and asymptomatic patients was 1:1.6.

    The study shows that saliva screens for celiac disease can be  effective in identifying celiac disease early in childhood.

    Also, for this study at least, the data shows full compliance with gluten-free diet in the children diagnosed with celiac disease.

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    I've been pursuing a diagnosis for my daughter's symptoms since she was 2 years old. I didn't suspect celiac disease until she was 6. That was the point when she was able to describe what she was feeling. Prior to that, she had chronic cyclical vomitting, lethargy, stomach aches, ADD behaviors. I was told repeatedly that she was "doing it for attention". After going gluten-fee, it was a mere 2 weeks later when she came bounding down the stairs to breakfast and announced that her tummy didn't hurt anymore! Her celiac disease tests were negative until she was 11. I would love to see this method of testing put into practice with every child. So simple!

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  • About Me

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,000 articles on celiac disease. His coursework includes studies in biology, anatomy, medicine, science, and advanced research, and scientific methods. He previously served as SF Health News Examiner for Examiner.com, and devised health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

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