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Comparative Study
. 2019 Mar;33(3):e22722.
doi: 10.1002/jcla.22722. Epub 2018 Nov 21.

Comparison of non-invasive tests with invasive tests in the diagnosis of celiac disease

Yasemin Derya Gülseren  1 , Ali Kudret Adiloğlu  1 , Mihriban Yücel  1 , Zuhal Dağ  2 , Nilnur Eyerci  3 , Rukiye Berkem  1 , Levent Filik  2 , Muzaffer Çaydere  4
Affiliations
Comparative Study

Comparison of non-invasive tests with invasive tests in the diagnosis of celiac disease

Yasemin Derya Gülseren et al. J Clin Lab Anal. 2019 Mar.

Abstract

Background/aims: Today, invasive diagnostic tests are necessary for definite diagnosis of adult celiac disease (CD). However, in selected children patients, the need for invasive tests is ceased. In this study, we evaluated adult patients according to the ESPGHAN (European Pediatric Gastroenterology Hepatology and Nutrition Society) criteria.

Methods: Thirty-nine patients (aged 17-66) with symptoms of CD were included. Serum samples were tested for total IgA, tTG-IgA (antitissue transglutaminase), tTG-IgG, DGP-IgA (antideamidated gliadin peptide), DGP-IgG, and EMA (endomysial antibodies). HLA-DQ typing was studied with PCR-SSP (sequence-specific primers) method. Biopsy samples were evaluated according to Marsh scoring.

Results: In CD patients, 71.4% (15/21) of the patients were diagnosed without biopsy according to the EPSGHAN criteria but when ESPGHAN's IgA tTG threshold value for children was taken into consideration (>200 IU/mL), the sensitivity decreased to 81%. Celiac disease diagnosed and control groups were compared in terms of HLA tissue types. DQ2.5 homozygous or DQ2.5/DQ2.2 was significantly higher in CD group, and DQ2- or DQ8-negative HLA tissue type was significantly higher in control group.

Conclusion: When serological tests, HLA typing, and clinical symptoms are all in favor of CD, biopsy may not be performed in selected adult CD patients.

Keywords: Celiac disease; HLA-DQ typing; autoantibody tests; diagnosis; diagnostic performance.

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Figures

Figure 1
Figure 1
Evaluation of patients with celiac disease diagnosis according to ESPGHAN criteria
Figure 2
Figure 2
Evaluation of patients who were excluded from celiac disease according to EPSGHAN criteria
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