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001-es BibID:	BIBFORM002285
Első szerző:	Korponay-Szabó Ilma (gyermekgyógyász)
Cím:	Population screening for coeliac disease in primary care by district nurses using a rapid antibody test : diagnostic accuracy and feasibility study / Korponay-Szabó Ilma, Szabados Katalin, Pusztai Jánosné, Uhrin Katalin, Ludmány Éva, Nemes Éva, Kaukinen Katri, Kapitány Anikó, Koskinen Lotta, Sipka Sándor, Imre Anikó, Mäki Markku
Dátum:	2007
Megjegyzések:	Objective To evaluate the feasibility and diagnostic accuracy of screening for coeliac disease by rapid detection of IgA antibodies to tissue transglutaminase performed in primary care. Design District nurses screened 6 year old children using rapid antibody testing of finger prick blood. They also collected capillary blood samples for laboratory determination of IgA and IgG antibodies to endomysium and IgA antibodies to tissue transglutaminase. Children with positive rapid test results were directly sent for biopsy of the small intestine. Setting Primary care in Jász-Nagykun-Szolnok county, Hungary. Participants 2690 children(77%of 6 year olds living in the county) and 120 nurses. Main outcome measures Positivity for antibodies to endomysium or transglutaminase in the laboratory and coeliac disease confirmed at biopsy. Results 37 children (1.4%, 95% confidence interval 0.9% to 1.8%) had biopsy confirmed coeliac disease. Only five of these children had been diagnosed clinically before screening. Rapid testinghad a 78.1%sensitivity(70.0% to 89.3%) and 100% specificity (88.4% to 100%) for a final diagnosis of coeliac disease by biopsy. Sensitivity was 65.1% (50.2% to 77.6%) and specificity was 100% (99.8% to 100%) compared with combined results of IgA and IgG laboratory tests. Trained laboratory workers detected 30 of the 31 newly diagnosed IgA competent patients with the rapid test kit used blindly. Median time to biopsy after a positive rapid test result was significantly shorter (20 days, range 4-148) than after a positive laboratory result (142 days, 70-256; P<0.001). Children with coeliac disease detected at screening were smaller and had worse health status than their peers but they improved on a gluten-free diet. Conclusions A simple rapid antibody test enabled primary care nurses to detect patients with coeliac disease in the community who were not picked up in clinical care. Extra training is needed to improve sensitivity.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:	British Medical Journal 335 : 7632 (2007), p. 1244-1277. -
További szerzők:	Szabados Katalin Pusztai Jánosné Uhrin Katalin Ludmány Éva Nemes Éva (1957-) (csecsemő- és gyermekgyógyász, gasztroenterológus) Kaukinen, Katri Kapitány Anikó (1979-) (molekuláris biológus) Koskinen, Lotta L. E. Sipka Sándor (1945-) (laboratóriumi szakorvos) Imre Anikó Mäki, Markku
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001-es BibID:	BIBFORM023715
Első szerző:	Nemes Éva (csecsemő- és gyermekgyógyász, gasztroenterológus)
Cím:	Gluten intake interferes with the humoral immune response to recombinant hepatitis B vaccine in patients with celiac disease / Nemes É., Lefler É., Szegedi L., Kapitány A., B. Kovács J., Balogh M., Szabados K., Tumpek J., Sipka S., Korponay-Szabó I. R.
Dátum:	2008
ISSN:	0031-4005
Megjegyzések:	Patients with celiac disease, who often carry human leukocyte antigen-DR3;DQ2, are prone to inadequate response to hepatitis B immunization. We evaluated vaccine response in relation to disease activity and whether previous treatment with a gluten-free diet influences the achievement of protective antibody titers. PATIENTS AND METHODS: We studied 128 children and adolescents with celiac disease and 113 age-matched control subjects. Twenty-two patients with celiac disease were prospectively immunized after diagnosis during dietary treatment (group 1). A total of 106 (group 2) and the control subjects received vaccination by mass immunization in schools at 14 years of age regardless of diet status and when celiac disease was still undiagnosed in 27 of these children. Diet compliance and celiac disease activity were monitored by measurement of antibodies against transglutaminase and endomysium. Vaccine response was determined by measuring antihepatitis B antibodies from serum. RESULTS: The seroconversion after hepatitis B vaccination was 95.5% in group 1. All of these patients carried human leukocyte antigen DQ2. The response rate in group 2 was 50.9% and correlated with gluten intake (untreated patients: 25.9%, non-strict diet: 44.4%, strict diet: 61.4%). Treated and compliant patients did not significantly differ from control subjects (75.2%). Thirty-seven antihepatitis B-negative patients with celiac disease received a booster during a controlled gluten-free diet, and 36 (97.3%) seroconverted, irrespective of the presence of human leukocyte antigen DQ2. CONCLUSIONS: Nonresponse to recombinant hepatitis B surface antigen may be a sign of undiagnosed celiac disease. However, there is a good vaccine response in adequately treated patients. Human leukocyte antigen DQ alleles do not seem to have a primary role. Revaccination is recommended during a controlled gluten-free diet.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:	Pediatrics. - 121 : 6 (2008), p. e1570-e1576. -
További szerzők:	Lefler Éva Szegedi László Kapitány Anikó (1979-) (molekuláris biológus) B. Kovács Judit Balogh Márta Szabados Katalin Tumpek Judit (1944-) (orvosi laboratóriumi szakorvos) Sipka Sándor (1945-) (laboratóriumi szakorvos) Korponay-Szabó Ilma (1959-) (gyermekgyógyász)
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