Cargando…

Diagnostic Accuracy of IgA Anti-Transglutaminase and IgG Anti-Deamidated Gliadin for Diagnosis of Celiac Disease in Children under Two Years of Age: A Systematic Review and Meta-Analysis

The need of adding the determination of anti-deamidated gliadin peptide (DGP) IgG to anti-transglutaminase (TTG) IgA antibodies for diagnosis of celiac disease (CD) in children <2 years of age is controversial. We performed a systematic review and meta-analysis to evaluate, by head-to-head compar...

Descripción completa

Detalles Bibliográficos
Autores principales: Catassi, Giulia N., Pulvirenti, Alfredo, Monachesi, Chiara, Catassi, Carlo, Lionetti, Elena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8746847/
https://www.ncbi.nlm.nih.gov/pubmed/35010880
http://dx.doi.org/10.3390/nu14010007
_version_ 1784630688685752320
author Catassi, Giulia N.
Pulvirenti, Alfredo
Monachesi, Chiara
Catassi, Carlo
Lionetti, Elena
author_facet Catassi, Giulia N.
Pulvirenti, Alfredo
Monachesi, Chiara
Catassi, Carlo
Lionetti, Elena
author_sort Catassi, Giulia N.
collection PubMed
description The need of adding the determination of anti-deamidated gliadin peptide (DGP) IgG to anti-transglutaminase (TTG) IgA antibodies for diagnosis of celiac disease (CD) in children <2 years of age is controversial. We performed a systematic review and meta-analysis to evaluate, by head-to-head comparison, the diagnostic accuracy of TTG IgA and DGP IgG antibodies. We searched PubMed, MEDLINE, and Embase databases up to January 2021. The diagnostic reference was intestinal biopsy. We calculated the sensitivity and specificity of these tests and the odds ratio (OR) between the tests. Fifteen articles were eligible for the systematic review and ten were eligible for the meta-analysis. Sensitivity and specificity were 0.96 (95% confidence interval (CI), 0.91–0.98) and 0.96 (95% CI, 0.85–0.99) for DGP IgG and 0.93 (95% CI, 0.88–0.97) and 0.98 (95% CI, 0.96–0.99) for TTG IgA, respectively. TTG IgA specificity was significantly higher (OR 9.3 (95% CI, 2.3–37.49); p < 0.001) while the sensitivity of DGP IgG was higher without reaching statistical significance (OR: 0.6 (95% CI, 0.24–1.51); p = 0.28). Both the meta-analysis and the systematic review showed that some children with early CD are missed without the DGP IgG test. In children <2 years of age, TTG IgA is the best CD screening test; however, the addition of DGP IgG may increase the diagnostic sensitivity.
format Online
Article
Text
id pubmed-8746847
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-87468472022-01-11 Diagnostic Accuracy of IgA Anti-Transglutaminase and IgG Anti-Deamidated Gliadin for Diagnosis of Celiac Disease in Children under Two Years of Age: A Systematic Review and Meta-Analysis Catassi, Giulia N. Pulvirenti, Alfredo Monachesi, Chiara Catassi, Carlo Lionetti, Elena Nutrients Review The need of adding the determination of anti-deamidated gliadin peptide (DGP) IgG to anti-transglutaminase (TTG) IgA antibodies for diagnosis of celiac disease (CD) in children <2 years of age is controversial. We performed a systematic review and meta-analysis to evaluate, by head-to-head comparison, the diagnostic accuracy of TTG IgA and DGP IgG antibodies. We searched PubMed, MEDLINE, and Embase databases up to January 2021. The diagnostic reference was intestinal biopsy. We calculated the sensitivity and specificity of these tests and the odds ratio (OR) between the tests. Fifteen articles were eligible for the systematic review and ten were eligible for the meta-analysis. Sensitivity and specificity were 0.96 (95% confidence interval (CI), 0.91–0.98) and 0.96 (95% CI, 0.85–0.99) for DGP IgG and 0.93 (95% CI, 0.88–0.97) and 0.98 (95% CI, 0.96–0.99) for TTG IgA, respectively. TTG IgA specificity was significantly higher (OR 9.3 (95% CI, 2.3–37.49); p < 0.001) while the sensitivity of DGP IgG was higher without reaching statistical significance (OR: 0.6 (95% CI, 0.24–1.51); p = 0.28). Both the meta-analysis and the systematic review showed that some children with early CD are missed without the DGP IgG test. In children <2 years of age, TTG IgA is the best CD screening test; however, the addition of DGP IgG may increase the diagnostic sensitivity. MDPI 2021-12-21 /pmc/articles/PMC8746847/ /pubmed/35010880 http://dx.doi.org/10.3390/nu14010007 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Catassi, Giulia N.
Pulvirenti, Alfredo
Monachesi, Chiara
Catassi, Carlo
Lionetti, Elena
Diagnostic Accuracy of IgA Anti-Transglutaminase and IgG Anti-Deamidated Gliadin for Diagnosis of Celiac Disease in Children under Two Years of Age: A Systematic Review and Meta-Analysis
title Diagnostic Accuracy of IgA Anti-Transglutaminase and IgG Anti-Deamidated Gliadin for Diagnosis of Celiac Disease in Children under Two Years of Age: A Systematic Review and Meta-Analysis
title_full Diagnostic Accuracy of IgA Anti-Transglutaminase and IgG Anti-Deamidated Gliadin for Diagnosis of Celiac Disease in Children under Two Years of Age: A Systematic Review and Meta-Analysis
title_fullStr Diagnostic Accuracy of IgA Anti-Transglutaminase and IgG Anti-Deamidated Gliadin for Diagnosis of Celiac Disease in Children under Two Years of Age: A Systematic Review and Meta-Analysis
title_full_unstemmed Diagnostic Accuracy of IgA Anti-Transglutaminase and IgG Anti-Deamidated Gliadin for Diagnosis of Celiac Disease in Children under Two Years of Age: A Systematic Review and Meta-Analysis
title_short Diagnostic Accuracy of IgA Anti-Transglutaminase and IgG Anti-Deamidated Gliadin for Diagnosis of Celiac Disease in Children under Two Years of Age: A Systematic Review and Meta-Analysis
title_sort diagnostic accuracy of iga anti-transglutaminase and igg anti-deamidated gliadin for diagnosis of celiac disease in children under two years of age: a systematic review and meta-analysis
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8746847/
https://www.ncbi.nlm.nih.gov/pubmed/35010880
http://dx.doi.org/10.3390/nu14010007
work_keys_str_mv AT catassigiulian diagnosticaccuracyofigaantitransglutaminaseandiggantideamidatedgliadinfordiagnosisofceliacdiseaseinchildrenundertwoyearsofageasystematicreviewandmetaanalysis
AT pulvirentialfredo diagnosticaccuracyofigaantitransglutaminaseandiggantideamidatedgliadinfordiagnosisofceliacdiseaseinchildrenundertwoyearsofageasystematicreviewandmetaanalysis
AT monachesichiara diagnosticaccuracyofigaantitransglutaminaseandiggantideamidatedgliadinfordiagnosisofceliacdiseaseinchildrenundertwoyearsofageasystematicreviewandmetaanalysis
AT catassicarlo diagnosticaccuracyofigaantitransglutaminaseandiggantideamidatedgliadinfordiagnosisofceliacdiseaseinchildrenundertwoyearsofageasystematicreviewandmetaanalysis
AT lionettielena diagnosticaccuracyofigaantitransglutaminaseandiggantideamidatedgliadinfordiagnosisofceliacdiseaseinchildrenundertwoyearsofageasystematicreviewandmetaanalysis