Immunoglobulin G antibodies against deamidated‐gliadin‐peptides outperform anti‐endomysium and tissue transglutaminase antibodies in children <2 years age

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Abstract:

Mubarak A, Gmelig‐Meyling FHJ, Wolters VM, Ten Kate FJW, Houwen RHJ. Immunoglobulin G antibodies against deamidated‐gliadin‐peptides outperform anti‐endomysium and tissue transglutaminase antibodies in children <2 years. APMIS 2011; 119: 894–900.

To investigate the usefulness of deamidated‐gliadin‐peptides‐antibodies in the diagnosis of celiac disease, serology was tested in 212 children suspected with celiac disease who had undergone a small‐intestinal‐biopsy. For deamidated‐gliadin‐peptides‐antibodies, two kits were tested. Positive and negative predictive values for IgA deamidated‐gliadin‐peptides‐antibodies using the Bindazyme‐kit were 89% and 74%, while the Quanta‐Lite‐kit had values of 89% and 85%, respectively. For the IgG subtype using the Bindazyme‐kit, these values were 85% and 89%, while they were 85% and 91% for the Quanta‐Lite‐kit. The positive predictive values for endomysium and tissue‐transglutaminase antibodies were disappointing (77% and 87%), although the negative predictive values were better (97% and 96%). When the analysis was restricted to the 41 children aged <2 years, no misclassifications occurred with IgG deamidated‐gliadin‐peptides‐antibodies giving 100% accuracy in both kits. The positive predictive value reached 100% for tissue‐transglutaminase antibodies and both kits for IgA deamidated‐gliadin‐peptides‐antibodies, while the negative predictive value was 94% in these assays. Positive and negative predictive values for endomysium antibodies were 96% and 93%, respectively. In conclusion, although deamidated‐gliadin‐peptides‐antibodies do not outperform anti‐endomysium antibodies in the total study population, the IgG subtype seems to be the best test in children aged <2 years, reaching 100% accuracy.

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1600-0463.2011.02817.x

Affiliations: 1: Departments of Pediatric Gastroenterology 2: Immunology 3: Pathology, University Medical Center Utrecht, Utrecht, The Netherlands

Publication date: December 1, 2011

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