title: Evaluating diagnostic accuracy of anti-tissue Transglutaminase IgA antibodies as first screening for Celiac Disease in very young children.
abstract: BACKGROUND
  Small bowel biopsy is the gold standard for Celiac Disease (CD) diagnosis, nevertheless serum assays are the first step in ascertaining a diagnosis of CD. New ESPGHAN Criteria 2012 (European Society of Pediatric Gastroenterology Hepatology and Nutrition) suggest using exclusively anti-tissue Transglutaminase IgA antibodies (anti-tTGA) as initial approach to symptomatic subjects. The aim of our study was to evaluate the diagnostic accuracy of anti-tTGA as initial screening assay for CD in a large cohort of pediatric patients.
  
  
  METHODS
  We selected 730 subjects aged between 6 months and 4 years ("Group A") and 348 subjects younger than 2 years (which are part of the 730 subjects) ("Group B"). We performed anti-Deamidated Gliadin Peptides IgA and IgG antibodies (a-DGP IgA/IgG) and anti-tTGA assays by ELISA test. We evaluated the agreement between anti-tTGA and a-DGP IgA/IgG assays and compared the diagnostic accuracy of a-DGP IgA/IgG with that of anti-tTGA in both groups of patients.
  
  
  RESULTS
  There was a substantial agreement between anti-tTGA and a-DGP IgA in "Group A" and an almost perfect agreement in "Group B"; the strength of agreement between anti-tTGA and a-DGP IgG was moderate in "Group A" and substantial in "Group B". anti-tTGA were more sensitive and specific than a-DGP IgA/IgG in both groups.
  
  
  CONCLUSIONS
  anti-tTGA could be used as initial screening assay for CD in all subjects from 6 months of age according to ESPGHAN Criteria 2012.
authors.affiliation: Department of Molecular Medicine and Medical Biotechnology/DAI of Laboratory Medicine, University of Naples Federico II, Naples, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Frulio
authors.affiliation: Department of Molecular Medicine and Medical Biotechnology/DAI of Laboratory Medicine, University of Naples Federico II, Naples, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Polimeno
authors.affiliation: Department of Molecular Medicine and Medical Biotechnology/DAI of Laboratory Medicine, University of Naples Federico II, Naples, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Palmieri
authors.affiliation: Department of Molecular Medicine and Medical Biotechnology/DAI of Laboratory Medicine, University of Naples Federico II, Naples, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Fumi
authors.affiliation: Department of Translational Medical Science/DAI of Pediatrics, University of Naples Federico II, Naples, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Auricchio
authors.affiliation: Department of Translational Medical Science/DAI of Pediatrics, University of Naples Federico II, Naples, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Piccolo
authors.affiliation: Department of Molecular Medicine and Medical Biotechnology/DAI of Laboratory Medicine, University of Naples Federico II, Naples, Italy. Electronic address: caranden@unina.it.
authors.forename: P
authors.initials: P
authors.lastname: Carandente Giarrusso
mesh_terms: D001323:Autoantibodies / Q000097:blood*; D002446:Celiac Disease / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D019204:GTP-Binding Proteins / Q000037:antagonists & inhibitors / Q000097:blood* / Q000276:immunology; D005903:Gliadin / Q000737:chemistry / Q000276:immunology; D006801:Humans; D007070:Immunoglobulin A / Q000737:chemistry*; D007074:Immunoglobulin G / Q000737:chemistry*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015997:Neonatal Screening; D010446:Peptide Fragments / Q000737:chemistry / Q000276:immunology; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D012680:Sensitivity and Specificity; D011503:Transglutaminases / Q000037:antagonists & inhibitors / Q000097:blood* / Q000276:immunology
chemical_list: D001323:Autoantibodies; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D010446:Peptide Fragments; D005903:Gliadin; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases; D019204:GTP-Binding Proteins
keywords: Celiac Disease; Children; Diagnostic accuracy; ELISA; anti-Deamidated Gliadin Peptides IgA and IgG antibodies; anti-tissue Transglutaminase IgA antibodies