Coeliac disease case finding and diet monitoring by point-of-care testing

I. R. Korponay-Szabó, T. Raivio, K. Laurila, J. Opre, R. Király, J. Kovács, K. Kaukinen, L. Fésüs, M. Mäki

Research output: Contribution to journalArticle

53 Citations (Scopus)

Abstract

Background: Immunoglobulin A class transglutaminase autoantibodies are highly predictive markers of active coeliac disease, a disorder difficult to recognize solely on clinical grounds. Aims: To develop and evaluate a simple rapid test for point-of-care detection of coeliac autoantibodies. Methods: The novel whole blood test utilizes the patient's endogenous transglutaminase in red blood cells for detection of transglutaminase-specific immunoglobulin A antibodies present in the blood sample, with normal plasma immunoglobulin A detection as positive test control. We evaluated 284 patients under suspicion of coeliac disease and undergoing jejunal biopsy, and 263 coeliac patients on a gluten-free diet, 383 being tested prospectively in a point-of-care setting. Results were compared with histology, conventional serum autoantibody results and dietary adherence. Results: The rapid test showed 97% sensitivity and 97% specificity for untreated coeliac disease, and identified all immunoglobulin A-deficient samples. Point-of-care testing found new coeliac cases as efficiently as antibody tests in laboratory. Coeliac autoantibodies were detected onsite in 21% of treated patients, while endomysial and transglutaminase antibodies were positive in 20% and 19%, respectively. The positivity rate correlated with dietary lapses and decreased on intensified dietary advice given upon positive point-of-care test results. Conclusions: Point-of-care testing was accurate in finding new coeliac cases and helped to identify and decrease dietary non-compliance.

Original languageEnglish
Pages (from-to)729-737
Number of pages9
JournalAlimentary Pharmacology and Therapeutics
Volume22
Issue number8
DOIs
Publication statusPublished - Oct 15 2005

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Celiac Disease
Transglutaminases
Abdomen
Point-of-Care Systems
Autoantibodies
Immunoglobulin A
Diet
Antibodies
Gluten-Free Diet
Immunoglobulin Isotypes
Hematologic Tests
Histology
Erythrocytes
Point-of-Care Testing
Biopsy
Sensitivity and Specificity
Serum

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

Coeliac disease case finding and diet monitoring by point-of-care testing. / Korponay-Szabó, I. R.; Raivio, T.; Laurila, K.; Opre, J.; Király, R.; Kovács, J.; Kaukinen, K.; Fésüs, L.; Mäki, M.

In: Alimentary Pharmacology and Therapeutics, Vol. 22, No. 8, 15.10.2005, p. 729-737.

Research output: Contribution to journalArticle

Korponay-Szabó, IR, Raivio, T, Laurila, K, Opre, J, Király, R, Kovács, J, Kaukinen, K, Fésüs, L & Mäki, M 2005, 'Coeliac disease case finding and diet monitoring by point-of-care testing', Alimentary Pharmacology and Therapeutics, vol. 22, no. 8, pp. 729-737. https://doi.org/10.1111/j.1365-2036.2005.02663.x
Korponay-Szabó, I. R. ; Raivio, T. ; Laurila, K. ; Opre, J. ; Király, R. ; Kovács, J. ; Kaukinen, K. ; Fésüs, L. ; Mäki, M. / Coeliac disease case finding and diet monitoring by point-of-care testing. In: Alimentary Pharmacology and Therapeutics. 2005 ; Vol. 22, No. 8. pp. 729-737.
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