A Brazilian experience of the self transglutaminase-based test for celiac disease case finding and diet monitoring.
OBJECTIVE
To evaluate the effectiveness of a rapid and easy fingertip whole blood point-of-care test for celiac disease (CD) case finding and diet monitoring.


METHODS
Three hundred individuals, 206 females (68.7%) and 94 males (31.3%), were submitted to a rapid and easy immunoglobulin-A-class fingertip whole blood point-of-care test in the doctor's office in order to make immediate clinical decisions: 13 healthy controls, 6 with CD suspicion, 46 treated celiacs, 84 relatives of the celiac patients, 69 patients with dyspepsia, 64 with irritable bowel syndrome (IBS), 8 with Crohn's disease and 9 with other causes of diarrhea.


RESULTS
Upper gastrointestinal endoscopy with duodenal biopsies was performed in patients with CD suspicion and in individuals with positive test outcome: in 83.3% (5/6) of the patients with CD suspicion, in 100% of the patients that admitted gluten-free diet transgressions (6/6), in 3.8% of first-degree relatives (3/79) and in 2.9% of patients with dyspepsia (2/69). In all these individuals duodenal biopsies confirmed CD (Marsh's histological classification). The studied test showed good correlation with serologic antibodies, endoscopic and histological findings.


CONCLUSIONS
The point-of-care test was as reliable as conventional serological tests in detecting CD cases and in CD diet monitoring.
Kotze
Lorete Maria da Silva
LM
Rua Bruno Filgueira, 369 - Cj 1205, CEP 80240-220, Curitiba, Paraná, Brazil. loretekotze@hotmail.com.
Brambila Rodrigues
Ana Paula
AP
Kotze
Luiz Roberto
LR
Nisihara
Renato Mitsunori
RM
D000906:Antibodies / Q000097:blood*; D001938:Brazil; D016022:Case-Control Studies; D002446:Celiac Disease / Q000175:diagnosis* / Q000178:diet therapy / Q000276:immunology; D055050:Diet, Gluten-Free / Q000009:adverse effects*; D004797:Enzyme-Linked Immunosorbent Assay; D005190:Family; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems / Q000592:standards; D011933:Reagent Kits, Diagnostic; D011503:Transglutaminases / Q000097:blood* / Q000276:immunology; D055815:Young Adult
D000906:Antibodies; D007070:Immunoglobulin A; D011933:Reagent Kits, Diagnostic; D011503:Transglutaminases