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Fingertip Rapid Point-of-care Test in Adult Case-finding in Celiac Disease

Celiac.com 10/23/2013 - Celiac disease remains seriously under diagnosed in adults and, in many places, often takes years and even decades to diagnose.

Photo: CC--kthmA team of researchers recently evaluated the usefulness of an on-site rapid fingertip whole blood point-of-care test (POCT) that would help primary workers to spot patients who might benefit from further diagnostic tests for celiac disease.

The research team included Alina Popp, Mariana Jinga, Ciprian Jurcut, Vasile Balaban, Catalina Bardas, Kaija Laurila, Florina Vasilescu, Adina Ene, Ioana Anca and Markku Mäki. They are affiliated with the University of Medicine and Pharmacy “Carol Davila,” the Institute for Mother and Child Care “Alfred Rusescu,” Central University Emergency Military Hospital “Dr. Carol Davila,” Str. Mircea Vulcanescu, in Bucharest, Romania and with theTampere Center for Child Health Research, University of Tampere and Tampere University Hospital, in Tampere, Finland.

Because celiac disease often runs in families, the team tested 148 healthy relatives of 70 Romanian index cases with biopsy-proven celiac disease, for a total of 87% of all first-degree family members, with a median age 36 years, for the presence of circulating autoantibodies.

In addition to using the POCT to measures blood erythrocyte self-TG2-autoantibody complexes on site, the team took blood samples for later evaluation of serum IgA-class endomysial antibodies (EMA).

The then tested all EMA-positive samples for transglutaminase 2 antibodies (TG2-IgA). They conducted blind analysis of all serological parameters in a centralized laboratory with no knowledge of the on site POCT result. The team recommended endoscopic small intestinal biopsies for all POCT- or EMA-test positive subjects.

Overall, 12 of 148 (8%) first-degree relatives showed positive results for the POCT, and all twelve tested serum EMA-positive. Only one other test subject showed a positive EMA test result.

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All remaining 135 healthy first-degree relatives showed negative results for both POCT and EMA.

Four subjects who tested positive for both POCT and EMA were negative for TG2-IgA. Ten out of thirteen of the antibody-positive subjects consented to endoscopy.

In all, eight out of nine first-degree relatives with celiac-type mucosal lesions of grade Marsh 2 (n = 3) or Marsh 3 (n = 6) showed positive results with the POCT.

The three POCT-positive subjects refused endoscopy tested positive for both EMA and TG2-IgA.

The fingertip whole blood rapid POCT could be a simple and cheap way to spot biomarkers and promote further testing for faster diagnosis of celiac disease.

The team is calling for further studies in adult case-finding in specialized outpatient clinics and in primary care.

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1 Response:

 
Mary Hines
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said this on
27 Oct 2013 12:14:31 AM PDT
Hopefully with this POCT we can get more people to screen.




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Ditto. However, this is what I can never understand about gluten free food. (see the bold bits which I've taken from the article) "We wanted to determine if gluten consumption will affect health in people with no apparent medical reasons to avoid gluten. Gluten-free foods often have less dietary fiber and other micronutrients, making them less nutritious and they also tend to cost more,? I wonder why what so much of what I eat that's gluten free doesn't have added vitamins - we of all people need fortification in our cereals and bread, surely?

Yeah we learned that the hard way. I am inclined to think (as I did initially) that it was JUST the Cheerios but as time is passing and she is not bouncing back I am worried that we need to strip away dairy again for a while.

Oh I have no issue with being dairy free personally but tell that to a 13 year old. We both went gluten-free at the same time and it has been mindlessly easy for me. But I am easy about food and no real food issues. I am far more adaptable. She comes to the table with her own unique set of issues that complicate just easily transitioning to dairy free versions of much loved favorites. To most they are jst that "substitutes" to her they are completely different foods and ones that she has no interest in eating. They don't satisfy her need for XYZ. It is like craving an apple and someone handing you a fish. For her anyway! LOL!

I believe the talk around this forum is that cheerios are not gluten free enough for people with celiac at this time. I don't know if anything has changed on that and when their lawyer calls me I'll quickly delete this. haha

Could be we generally say get off of dairy for a few months when going gluten free. The part of the intestines that produce the enzymes, and help break down dairy are associated with the tips of the villi, which are the most damaged if not gone in celiacs. THIS is why most of us end up with a lactose intolerance early on. And most can introduce it later after healing. As to her symptoms with it there was a bunch of research about dairy permeated the gut and causing neurological issues in a autism study I was looking at years ago. And there have been other studies about damaged intestines and how the hormones in milk can easier effect ones body. Personally I also have a huge grudge against dairy on a personal level as it is not natural to suck on a cows tits and drink the stuff, nor your dogs, nor a rabbits......I mean come on even Human Breast milk you would find odd to drink as an adult right? Back in the past dairy was a great way to get calories and fats when there was famine, etc around I mean it is meant to make a calf grow into a 500+lb cow. But on a genetic and hormonal level it is not really for human consumption and now days the whole corporate BS propaganda push and dairy farms shove that oh its healthy stuff down your throat. There are plenty of dairy free options for everything feel free to message me if you need help finding anything I have been dairy free for over a decade.