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001-es BibID:BIBFORM044267
Első szerző:Giersiepen, Klaus
Cím:Accuracy of Diagnostic Antibody Tests for Coeliac Disease in Children / Giersiepen Klaus, Lelgemann Monika, Stuhldreher Nina, Ronfani Luca, Husby Steffen, Koletzko Sibylle, Korponay-Szabó Ilma R., the ESPGHAN Working Group on Coeliac Disease Diagnosis
Dátum:2012
ISSN:0277-2116
Megjegyzések:OBJECTIVE: The aim of this study was to summarise the evidence from 2004 toSeptember 2009 on the performance of laboratory-based serological and point ofcare (POC) tests for diagnosing coeliac disease (CD) in children using histology as reference standard.PATIENTS AND METHODS: We searched MEDLINE and EMBASE for studies reporting onchildren for tests based on IgA and IgG anti-gliadin (AGA), endomysial (EmA),anti-transglutaminase-2 (TG2), and anti-deamidated gliadin peptides (DGP)antibodies or POC tests. For inclusion, histological analysis of duodenalbiopsies and sensitivity and specificity for index tests had to be reported. Datawere pooled and summary measures calculated for sensitivity, specificity,positive and negative likelihood ratios ("LR+", "LR-"), and diagnostic oddsratios (DOR). In case of elevated statistical heterogeneity, studies reaching 90%sensitivity or specificity were reported.RESULTS: A total of 2510 articles were reviewed; 16 entered meta-analysis,reporting on 3110 patients (1876 with CD, 1234 without CD). For IgA-EmA,sensitivity was ?90% in 7/11 studies and pooled specificity 98.2%. ForIgA-anti-TG2, 11/15 studies yielded sensitivities ?90% and 13/15 specificities?90%. For IgA-DGP, sensitivity ranged between 80.7% and 95.1% (specificity86.3%-93.1%); for IgG-DGP between 80.1% and 98.6% (specificity 86.0-96.9%).IgA-EmA had the highest pooled DOR (554) and LR+ (31.8) for a laboratory test,followed by IgA-anti-TG2, IgG-DGP, IgA-DGP and IgA-AGA. POC tests showed a pooledsensitivity of 96.4% for IgA-TG2 (specificity 97.7%).CONCLUSIONS: IgA-EmA and IgA-anti-TG2 tests appear highly accurate to diagnoseCD. IgG-anti-DGP tests may help in excluding CD. IgA-AGA and IgA-DGP tests showinferior accuracy. POC tests may achieve high accuracy in the hands ofexperienced readers, but IgA-anti-TG2/EmA were superior.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:Journal Of Pediatric Gastroenterology And Nutrition. - 54 : 2 (2012), p. 229-241. -
További szerzők:Lelgemann, Monika Stuhldreher, Nina Ronfani, Luca Husby, Steffen Koletzko, Sibylle Korponay-Szabó Ilma (1959-) (gyermekgyógyász) the ESPGHAN Working Group on Coeliac Disease Diagnosis
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