TY - JOUR T1 - Accuracy of diagnostic antibody tests for coeliac disease in children: summary of an evidence report. JF - J Pediatr Gastroenterol Nutr Y1 - 2012 A1 - Giersiepen, Klaus A1 - Lelgemann, Monika A1 - Stuhldreher, Nina A1 - Ronfani, Luca A1 - Husby, Steffen A1 - Koletzko, Sibylle A1 - Korponay-Szabó, Ilma R KW - Autoantibodies KW - Biological Markers KW - Celiac Disease KW - Child KW - Gliadin KW - GTP-Binding Proteins KW - Humans KW - Immunoglobulin A KW - Immunoglobulin G KW - Point-of-Care Systems KW - Sensitivity and Specificity KW - Transglutaminases AB -

OBJECTIVE: The aim of this study was to summarise the evidence from 2004 to September 2009 on the performance of laboratory-based serological and point of care (POC) tests for diagnosing coeliac disease (CD) in children using histology as reference standard.

PATIENTS AND METHODS: We searched MEDLINE and EMBASE for studies reporting on children for tests based on IgA and IgG anti-gliadin (AGA), endomysial (EmA), anti-transglutaminase-2 (TG2), and anti-deamidated gliadin peptides (DGP) antibodies or POC tests. For inclusion, histological analysis of duodenal biopsies and sensitivity and specificity for index tests had to be reported. Data were pooled and summary measures calculated for sensitivity, specificity, positive and negative likelihood ratios ("LR+", "LR-"), and diagnostic odds ratios (DOR). In case of elevated statistical heterogeneity, studies reaching 90% sensitivity or specificity were reported.

RESULTS: A total of 2510 articles were reviewed; 16 entered meta-analysis, reporting on 3110 patients (1876 with CD, 1234 without CD). For IgA-EmA, sensitivity was ≥90% in 7/11 studies and pooled specificity 98.2%. For IgA-anti-TG2, 11/15 studies yielded sensitivities ≥90% and 13/15 specificities ≥90%. For IgA-DGP, sensitivity ranged between 80.7% and 95.1% (specificity 86.3%-93.1%); for IgG-DGP between 80.1% and 98.6% (specificity 86.0-96.9%). IgA-EmA had the highest pooled DOR (554) and LR+ (31.8) for a laboratory test, followed by IgA-anti-TG2, IgG-DGP, IgA-DGP and IgA-AGA. POC tests showed a pooled sensitivity of 96.4% for IgA-TG2 (specificity 97.7%).

CONCLUSIONS: IgA-EmA and IgA-anti-TG2 tests appear highly accurate to diagnose CD. IgG-anti-DGP tests may help in excluding CD. IgA-AGA and IgA-DGP tests show inferior accuracy. POC tests may achieve high accuracy in the hands of experienced readers, but IgA-anti-TG2/EmA were superior.

VL - 54 IS - 2 U1 - http://www.ncbi.nlm.nih.gov/pubmed/22266486?dopt=Abstract ER - TY - JOUR T1 - Therapeutic strategy in p47-phox deficient chronic granulomatous disease presenting as inflammatory bowel disease. JF - J Allergy Clin Immunol Y1 - 2010 A1 - Freudenberg, Folke A1 - Wintergerst, Uwe A1 - Roesen-Wolff, Angela A1 - Albert, Michael H A1 - Prell, Christine A1 - Strahm, Brigitte A1 - Koletzko, Sibylle A1 - Ehl, Stephan A1 - Roos, Dirk A1 - Tommasini, Alberto A1 - Ventura, Alessandro A1 - Belohradsky, Bernd H A1 - Seger, Reinhard A1 - Roesler, Joachim A1 - Güngör, Tayfun KW - Age of Onset KW - Anti-Bacterial Agents KW - Antibodies, Monoclonal KW - Child KW - Drug Therapy, Combination KW - Gene Deletion KW - Granulomatous Disease, Chronic KW - Humans KW - Inflammatory Bowel Diseases KW - Male KW - NADPH Oxidase KW - Steroids KW - Treatment Outcome KW - Vidarabine VL - 125 IS - 4 U1 - http://www.ncbi.nlm.nih.gov/pubmed/20371400?dopt=Abstract ER -