Diagnostic screening for subclinical celiac disease using a rapid test in children aged 2-4.
BACKGROUND
Our aim is to study the prevalence of subclinical celiac disease (CD) and analyze the diagnostic yield of a new rapid test in children aged 2-4.


METHODS
We carried out a cross-sectional study in a sample population of children aged 2-4 from the same metropolitan area. We recruited apparently healthy subjects, and collected clinical, anthropometric, analytical, and serological variables. We also tested for anti-gliadin IgA and anti-transglutaminase IgG and IgA using a rapid immunochromatographic test CD1WB and CD2WB (Operon, Zaragoza, Spain).


RESULTS
One hundred and ninety-eight children were recruited, signed the informed consent form, and completed the protocol (mean age 32.3 ± 9.2 mo, 53% males). CD prevalence according to the serological tests was 3% (CI 95%, 1.4-6.4%). Biopsies were used to confirm the diagnosis in all suspected cases. The sensitivity and negative predictive value of the CD2WB immunochromatographic test strip were 100% and 1, respectively. The sensitivity of CD1WB was 16.6% and its specificity was high (89.1%).


CONCLUSIONS
The prevalence of subclinical CD in the sample group of 2-4-y old was higher than that found by other authors. The CD2WB immunochromatographic test strip is an excellent diagnostic screening tool with high sensitivity and negative predictive value.
Pediatrics Unit, Maracena Clinical Management Unit, Distrito Sanitario Metropolitano-Granada, Spain.
Maria Vega
MV
Almazán
Pediatrics Unit, Maracena Clinical Management Unit, Distrito Sanitario Metropolitano-Granada, Spain.
Eduardo
E
Ortega
Pediatric Gastroenterology Unit, Virgen de las Nieves University Hospital, Granada, Spain.
Rosario
R
Moreno Torres
Pediatrics Unit, Maracena Clinical Management Unit, Distrito Sanitario Metropolitano-Granada, Spain.
Mercedes
M
Tovar
Pediatric Gastroenterology Unit, Virgen de las Nieves University Hospital, Granada, Spain.
Julio
J
Romero
Pediatric Gastroenterology Unit, Virgen de las Nieves University Hospital, Granada, Spain.
Miguel Ángel
MÁ
López-Casado
Clinical Diagnostic Department, Virgen de las Nieves University Hospital, Granada, Spain.
Laura
L
Jáimez
Instituto de Investigación Biosanitaria de Granada, Granada, Spain.
Juan
J
Jiménez-Jáimez
Pediatrics Unit, Maracena Clinical Management Unit, Distrito Sanitario Metropolitano-Granada, Spain.
Alicia
A
Ballesteros
IMIBIC/Reina Sofía University Hospital/University of Córdoba, Córdoba, Spain.
Javier
J
Caballero-Villarraso
Pediatric Gastroenterology Unit, Virgen de las Nieves University Hospital, Granada, Spain.
José
J
Maldonado
D000886:Anthropometry; D001323:Autoantibodies / Q000737:chemistry; D001706:Biopsy; D002446:Celiac Disease / Q000175:diagnosis*; D002675:Child, Preschool; D002846:Chromatography, Affinity; D003430:Cross-Sectional Studies; D005260:Female; D005903:Gliadin / Q000737:chemistry; D006801:Humans; D007070:Immunoglobulin A / Q000737:chemistry; D007074:Immunoglobulin G / Q000737:chemistry; D008297:Male; D011237:Predictive Value of Tests; D015995:Prevalence; D012680:Sensitivity and Specificity; D013030:Spain; D011503:Transglutaminases / Q000737:chemistry; D014505:Urban Population
D001323:Autoantibodies; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D005903:Gliadin; D011503:Transglutaminases