Evaluation of mucosal status in the follow-up of pediatric patients with celiac disease: the role of serology

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Sengul O. K., Akkelle B., Ay P., Volkan B., Tutar E., Celikel Ç., ...Daha Fazla

EUROPEAN JOURNAL OF PEDIATRICS, cilt.181, sa.9, ss.3283-3289, 2022 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 181 Sayı: 9
  • Basım Tarihi: 2022
  • Doi Numarası: 10.1007/s00431-022-04535-3
  • Dergi Adı: EUROPEAN JOURNAL OF PEDIATRICS
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, CINAHL, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.3283-3289
  • Anahtar Kelimeler: Celiac disease, Endomysium IgA, Pediatric, Serology, Tissue transglutaminase IgA, PERSISTENT VILLOUS ATROPHY, GLUTEN-FREE DIET, RECOVERY, TRANSGLUTAMINASE, PREVALENCE, GUIDELINES, ANTIBODIES, DIAGNOSIS, CHILDREN, SOCIETY
  • Marmara Üniversitesi Adresli: Evet

Özet

Recent guidelines suggest non-biopsy serology-based approach for the diagnosis of celiac disease; however, there is no evidence-based data regarding noninvasive follow-up of mucosal healing. The aim of this study is to investigate the efficacy of serology in reflecting mucosal status in the follow-up of pediatric patients with celiac disease. This is a validation study conducted at a university hospital. Patients who had biopsy proven celiac disease (Marsh III) at diagnosis, and had been followed-up for at least 12 months, were prospectively evaluated with duodenal biopsies. tTG-IgA and EMA tests were performed on the day of endoscopy. One hundred four patients with a mean age of 7.4 +/- 4.02 years were included in the study. The sensitivity and specificity of tTG-IgA were 85.2% and 61% respectively, with a high negative predictive value (NPV) of 92.2% but a very low positive predictive value (PPV) of 43.4%. We found that a cutoff value of 68.5 U/mL for tTG-IgA had a sensitivity, specificity of 85.2% and 85.7% respectively. The AUC was 0.891. The sensitivity and specificity of EMA was 77.8% and 87% respectively, with a high NPV of 91.8% but low PPV of 67.7%.