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Testing IgG and IgA Antibodies Against Gliadin Not Helpful for Diagnosing Celiac Disease in Children Under 2 Years Old

Celiac.com 08/16/2012 - Tests for blood antibodies against native gliadin (anti-nGli) are still often assumed to perform better in the diagnosis of celiac disease in young children than tests for antibodies to deamidated gliadin (anti-dGli), tissue transglutaminase (anti-tTG), and endomysium (EmA).

Photo: CC--Håkan Dahlström.A team of researchers recently set out to determine whether testing IgG and IgA antibodies Against native gliadin was best for diagnosing celiac disease in children under 2-years old. Specifically they wanted to compare the performance of assays for anti-nGli, anti-dGli, anti-tTG, and EmA in this age group.

The research team included T. Richter, X. Bossuyt, P. Vermeersch, H.H. Uhlig, M. Stern, A. Hauer, K.P. Zimmer, L. Mearin, J.H. Roo, C. Dähnrich, and T. Mothes.

They are affiliated with the University Children's Hospital, the Children's Hospital of the Clinical Centre, "Sankt Georg," and the Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics at University Hospital in Leipzig, Germany; with the Department Laboratory Medicine of University Hospital in Leuven, Belgium, the University Children's Hospital in Tübingen, Germany, the University Children's Hospital in Graz, Austria, the University Children's Hospital in Giessen, Germany, the Department of Paediatrics at Leiden University Medical Centre in Leiden, The Netherlands, and with EUROIMMUN Medizinische Labordiagnostika GmbH in Lübeck, Germany.

For their study, they conducted a retrospective analysis of 184 children. The study group included 42 children with celiac disease under normal diet, and a control group of 142 children up to 2 years of age.

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The team measured immunoglobulin (Ig) A- and IgG-anti-dGli, IgA- and IgG-anti-nGli, IgA- and IgG-anti-tTG, and IgA-EmA in blood samples. They calculated areas under receiver operating characteristics curves, sensitivities, specificities, positive and negative predictive values, positive and negative likelihood ratios, as well as diagnostic odds ratios.

When all the data was complete, they found that only tests for IgG-anti-dGli, IgA-anti-tTG, and IgA-EmA had high specificity (≥0.96) connected with high sensitivity (≥0.86), with high positive predictive values (≥0.52 and ≥0.69 at pretest probabilities of 0.05 and 0.1, respectively) and negative predictive values (≥0.99 and ≥0.98 at pretest probabilities of 0.05 and 0.1, respectively).

These tests also showed high positive likelihood ratio (≥24) at low negative likelihood ratio (≤0.15) and high diagnostic odds ratios (≥136).

From their data, the team concluded that using anti-nGli tests to diagnose celiac disease in young children was not helpful. They maintain that IgA-anti-tTG, IgA-EmA, and IgG-anti-dGli provided much more reliable results than anti-nGli in diagnosing celiac disease in young children.

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Woodrow
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said this on
25 Aug 2012 5:38:05 AM PDT
I love reading a post that will make men and women think.

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VSL #3 is safe and powerful probiotic. You get it at Costco in pharmacy or online. Metamucil is too hard on my system too. Psyllium husk is easier on the system and I tolerated it a little better. It did nothing for my husband because it was too gentle for him.

You might want to have your GI test for SIBO. Similar gut symptoms, common in celiacs, often agrivated by probiotics because you are adding more microbes to the overgrowth (FYI, the overgrowth is typically good bacteria is the wrong place). That's one of the next things they look for in a celiac still having symptoms.

thank you i will look for it. i was switching around ( culturelle, walgreens probiotic, walgreens probiotic with enzymes, just plain digestive enzymes) so, i know what you mean. at that point, i couldn't tell what was messing with my gut and what wasn't bothering me. ima try those, and *just* those and see how it goes. thanx again!

I found that I did not have enough iodine in my diet... so I take a Kelp pill... every day or so... I use Kosher salt and Pink Salt... so I need the iodine... I am shocked by what my ankles look like... I was always swollen... If you can eat shellfish... you should not have any issues with this...