Efficacy Study of Anti-Endomysium Antibodies for Celiac Disease Diagnosis: A Retrospective Study in a Spanish Pediatric Population

被引:7
|
作者
Roca, Maria [1 ]
Donat, Ester [1 ,2 ]
Marco-Maestud, Natalia [1 ]
Masip, Etna [1 ,2 ]
Hervas-Marin, David [3 ]
Ramos, David [4 ]
Polo, Begona [1 ,2 ]
Ribes-Koninckx, Carmen [1 ,2 ]
机构
[1] Inst Invest Sanitaria La Fe, Celiac Dis & Digest Immunopathol Unit, Valencia 46026, Spain
[2] Hosp Univ & Politecn La Fe, Pediat Gastrohepathol Unit, Valencia 46026, Spain
[3] Inst Invest Sanitaria La Fe, Stat Unit, Valencia 46026, Spain
[4] Hosp Univ & Politecn La Fe, Pathol Serv, Valencia 46026, Spain
关键词
Celiac disease; anti-endomysium antibodies; anti-tissue transglutaminase antibodies; pediatric population; ANTITISSUE TRANSGLUTAMINASE ANTIBODIES; PRIMERS PCR-SSP; TISSUE TRANSGLUTAMINASE; CHILDREN; RISK; AMPLIFICATION; ACCURACY; BIOPSY;
D O I
10.3390/jcm8122179
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The aim of this study was to assess the efficacy of anti-endomysium antibodies (EMA) as a serological marker for celiac disease (CD) diagnosis in a pediatric population. A retrospective study of pediatric patients who underwent a CD serological markers study: EMA and anti-tissue transglutaminase antibodies (anti-TG2). Clinical symptomatology, degree of histological lesion, human leukocyte antigen (HLA) haplotype compatible with CD (HLA DQ2 and/or DQ8), and final diagnosis were taken into account. We included 445 patients who were classified in two groups according to the final diagnosis. Group 1: 232 children with CD, 91.4% of whom exhibited small intestinal villous atrophy, 228 being EMA-positive and four EMA-negative. Group 2: 213 children with a non-CD diagnosis, 212 EMA negative and one EMA positive. Both antibodies, EMA and anti-TG2, reached similar sensitivities, 98% and 99% respectively, while EMA had a higher specificity (99%) than anti-TG2 (93%). By using both markers combined, compared to using anti-TG2 alone, 5.7% of patients are better diagnosed. However, when we compare the efficacy of EMA and anti-TG2 in asymptomatic and symptomatic patients, the sensitivity of EMA is 98% irrespective of symptoms, thus higher than for anti-TG2 >= 10 x upper limit of normal (ULN) (respectively 77% and 84%). Our results support the use of EMA to increase CD diagnostic accuracy in a non-biopsy approach, especially in asymptomatic children.
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页数:12
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