title: Antibodies against synthetic deamidated gliadin peptides as predictors of celiac disease: prospective assessment in an adult population with a high pretest probability of disease.
abstract: BACKGROUND
  Noninvasive serologic tests have shown high diagnostic accuracy for celiac disease (CD) in selected populations. Our aim was to determine prospectively the performance of CD-related serology in individuals undergoing intestinal biopsy because of clinical suspicion of small-bowel disorders.
  
  
  METHODS
  We enrolled 141 unselected consecutive adult patients attending a small-bowel disease clinic. Patients underwent endoscopy and biopsy; serum samples were obtained at that time for measurements of anti-tissue transglutaminase (a-tTG), IgA and IgG anti-deamidated gliadin-related peptide (a-DGP), and IgA antiactin antibodies (AAAs). Characterization of patients was based on histological criteria (Marsh type II lesion or greater).
  
  
  RESULTS
  The prevalence of CD was 42.5%. Sensitivity, specificity, and positive and negative predictive values were >90% for most assays. Diagnostic accuracy based on ROC curve analysis was similar for all assays [area under the curve (95% CI): 0.996 (0.967-0.998) for a-tTG, 0.995 (0.964-0.998) for IgA a-DGP, 0.989 (0.954-0.999) for IgG a-DGP, 0.996 (0.966-0.998) for blended conjugated of IgA + IgG a-DGP in a single assay, and 0.967 (0.922-0.990) for AAA]. The combinations of 2 tests, IgG a-DGP plus IgA a-tTG or the single blended conjugate detecting IgA + IgG a-DGP plus IgA a-tTG had 100% positive and negative predictive values if concentrations of both tests in either combination were above or below the cutoff.
  
  
  CONCLUSIONS
  In a population with high pretest probability, the newly developed a-DGP tests have diagnostic accuracy that is at least equivalent to that of established assays.
authors: Department of Medicine, Hospital de Gastroenterología "Dr. Carlos Bonorino Udaondo", Buenos Aires, Argentina.
authors: Sonia
authors: S
authors: Niveloni
authors: Emilia
authors: E
authors: Sugai
authors: Ana
authors: A
authors: Cabanne
authors: Horacio
authors: H
authors: Vazquez
authors: Julio
authors: J
authors: Argonz
authors: Edgardo
authors: E
authors: Smecuol
authors: María L
authors: ML
authors: Moreno
authors: Fabio
authors: F
authors: Nachman
authors: Roberto
authors: R
authors: Mazure
authors: Zulema
authors: Z
authors: Kogan
authors: Juan C
authors: JC
authors: Gomez
authors: Eduardo
authors: E
authors: Mauriño
authors: Julio C
authors: JC
authors: Bai
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000097:blood*; D001706:Biopsy; D002446:Celiac Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology; D004386:Duodenum / Q000473:pathology; D005260:Female; D005903:Gliadin / Q000276:immunology*; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood*; D007074:Immunoglobulin G / Q000097:blood*; D007413:Intestinal Mucosa / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010455:Peptides / Q000276:immunology*; D015995:Prevalence; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D011503:Transglutaminases / Q000276:immunology
chemical_list: D001323:Autoantibodies; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D010455:Peptides; D005903:Gliadin; D011503:Transglutaminases