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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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001-es BibID:	BIBFORM044266
Első szerző:	Husby, Steffen
Cím:	European Society for Pediatric Gastroenterology, Hepatology, and Nutrition Guidelines for the Diagnosis of Coeliac Disease / Husby, S., Koletzko, S., Korponay-Szabó, I. R., Mearin, M. L., Phillips, A., Shamir, R., Troncone, R., Giersiepen, K., Branski, D., Catassi, C., Lelgeman, M., Mäki, M., Ribes-Koninckx, C., Ventura, A., Zimmer, K. P., the ESPGHAN Working Group on Coeliac Disease Diagnosis, the ESPGHAN Gastroenterology Committee
Dátum:	2012
ISSN:	0277-2116
Megjegyzések:	OBJECTIVE: Diagnostic criteria for coeliac disease (CD) from the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) were published in 1990. Since then, the autoantigen in CD, tissue transglutaminase, has been identified; the perception of CD has changed from that of a rather uncommon enteropathy to a common multiorgan disease strongly dependent on the haplotypes human leukocyte antigen (HLA)-DQ2 and HLA-DQ8; and CD-specific antibody tests have improved.METHODS:A panel of 17 experts defined CD and developed new diagnostic criteria based on the Delphi process. Two groups of patients were defined with different diagnostic approaches to diagnose CD: children with symptoms suggestive of CD (group 1) and asymptomatic children at increased risk for CD (group 2). The 2004 National Institutes of Health/Agency for Healthcare Research and Quality report and a systematic literature search on antibody tests for CD in paediatric patients covering the years 2004 to 2009 was the basis for the evidence-based recommendations on CD-specific antibody testing.RESULTS:In group 1, the diagnosis of CD is based on symptoms, positive serology, and histology that is consistent with CD. If immunoglobulin A anti-tissue transglutaminase type 2 antibody titers are high (>10 times the upper limit of normal), then the option is to diagnose CD without duodenal biopsies by applying a strict protocol with further laboratory tests. In group 2, the diagnosis of CD is based on positive serology and histology. HLA-DQ2 and HLA-DQ8 testing is valuable because CD is unlikely if both haplotypes are negative.CONCLUSIONS:The aim of the new guidelines was to achieve a high diagnostic accuracy and to reduce the burden for patients and their families. The performance of these guidelines in clinical practice should be evaluated prospectively.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban celiac disease
Megjelenés:	Journal Of Pediatric Gastroenterology And Nutrition 54 : 1 (2012), p. 136-160. -
További szerzők:	Koletzko, Sibylle Korponay-Szabó Ilma (1959-) (gyermekgyógyász) Mearin, Maria Luisa Phillips, A. Shamir, R. Troncone, Riccardo Giersiepen, Klaus Branski, D. Catassi, Carlo Lelgemann, Monika Mäki, Markku Ribes-Koninckx, Carmen Ventura, Alessandro Zimmer, Klaus-Peter the ESPGHAN Working Group on Coeliac Disease Diagnosis the ESPGHAN Gastroenterology Committee
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