Serologic Diagnosis of Celiac Disease

2020 ◽  
Author(s):  
Tadeusz P. Chorzelski ◽  
Ernst H. Beutner ◽  
Tadeusz K. Zalewski ◽  
Vijay Kumar
Keyword(s):  
Celiac Disease ◽  
Serologic Diagnosis

scholarly journals A113 COST SAVINGS OF SEROLOGIC VERSUS BIOPSY PROVEN DIAGNOSIS OF PEDIATRIC CELIAC DISEASE

2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 131-132
Author(s):  
M Wiepjes ◽  
H Q Huynh ◽  
J Wu ◽  
M Chen ◽  
L Shirton ◽  
...  
Keyword(s):  
Health Care ◽  
Celiac Disease ◽  
North America ◽  
Cost Saving ◽  
Health Care System ◽  
Cost Savings ◽  
Serologic Diagnosis ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Care System

Abstract Background Celiac disease (CD) affects approximately one percent of the population in Canada and the United States. At present, endoscopic diagnosis (ED) of CD remains the gold standard in North America, despite mounting evidence and validated European guidelines for serologic diagnosis (SD). Within publicly funded healthcare systems there is pressure to ensure optimal resource utilization and cost efficiency, including for endoscopic services. At Stollery Children’s Hospital, Edmonton, Canada, we have adopted serologic diagnosis as routine practice since 2016. Aims The aim of this study is to estimate cost savings, i.e. hard dollar savings and capacity improvements, to the health care system as well as impacts on families in regard to reduced work days lost and missing child school days for SD versus ED. Initial cost saving data is presented. Methods Micro-costing methods were used to determine health care resource use in patients undergoing ED or SD from 2017–2018. SD testing included anti-tissue glutaminase antibody (aTTG) ≥200IU/mL (on two occasions), human leukocyte antigen (HLA) DQA5/DQ2, blood sampling, transport and laboratory costs. ED diagnosis included gastroenterologist, anesthetist, OR equipment, staff, overhead and histopathology. Cost of each unit of resource was obtained from the schedule of medical benefits (Alberta) and reported average ambulatory cost for day hospital endoscopy for Stollery Children’s Hospital determined in 2016; reported in CAN$. Results Between March 2017-December 2018, 473 patients were referred for diagnosis of CD; 233 had ED and 127 SD. Estimated cost for ED was $1240 per patient; for SD was $85 per patient (6.8% of ED cost). Based on 127 patients not requiring endoscopy and a cost saving of $1155 per patient there was a total cost savings of $146,685 over 22 months. Conclusions A SD approach presents a significant cost savings to the public health care system. It also frees up valuable endoscopic resources, and limits exposure of children to the immediate and long-term risks associated with anesthesia and biopsy. SD also decreases time to diagnosis and the cost of the process to families (lost days of school/work, travel costs etc.). Our costing data can be used in combination with mounting evidence on the test performance of SD versus ED to determine cost-effectiveness of serological diagnosis for pediatric CD. Given the potential for cost saving and more efficient operating room utilization, SD for pediatric CD warrants further investigation in North America. Funding Agencies None

scholarly journals Serologic diagnosis of celiac disease: May it be suitable for adults?

2021 ◽  
Vol 27 (42) ◽  
pp. 7233-7239
Author(s):  
Giuseppe Losurdo ◽  
Milena Di Leo ◽  
Edoardo Santamato ◽  
Monica Arena ◽  
Maria Rendina ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Serologic Diagnosis

scholarly journals Optimization of serologic diagnosis of celiac disease in the pediatric setting

2020 ◽  
Vol 19 (5) ◽  
pp. 102513 ◽  
Author(s):  
Laura Bogaert ◽  
Mathieu Cauchie ◽  
Lieve Van Hoovels ◽  
Pieter Vermeersch ◽  
Walter Fierz ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Serologic Diagnosis ◽  
Pediatric Setting

OC.05.3 SEROLOGIC DIAGNOSIS OF CELIAC DISEASE IN ADULTS: AN UNFULFILLED QUESTION

2021 ◽  
Vol 53 ◽  
pp. S112
Author(s):  
G. Losurdo ◽  
E. Santamato ◽  
A. Giangaspero ◽  
E. Ierardi ◽  
A. Di Leo
Keyword(s):  
Celiac Disease ◽  
Serologic Diagnosis

Combining antibody tests and taking into account antibody levels improves serologic diagnosis of celiac disease

2015 ◽  
Vol 53 (10) ◽  
Author(s):  
Matthijs Oyaert ◽  
Pieter Vermeersch ◽  
Gert De Hertogh ◽  
Martin Hiele ◽  
Nathalie Vandeputte ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Tissue Transglutaminase ◽  
Human Leukocyte ◽  
Duodenal Biopsy ◽  
Hla Typing ◽  
High Antibody ◽  
Antibody Testing ◽  
Likelihood Ratios ◽  
Serologic Diagnosis ◽  
Antibody Levels

AbstractThe European Society for Pediatric Gastroenterology and Nutrition states that if IgA anti-tissue transglutaminase (tTG) exceeds 10 times the upper limit of normal (ULN), there is the possibility to diagnose celiac disease (CD) without duodenal biopsy, if supported by anti-endomysium testing and human leukocyte antigen (HLA) typing. We aimed to evaluate whether combining IgA tTG and IgG anti-deamidated gliadin peptide (DGP) antibody testing and taking into account the antibody levels improves clinical interpretation.We calculated likelihood ratios for various test result combinations using data obtained from newly diagnosed CD patients (n=156) [13 children <2 years, 45 children between 2 and 16 years, and 98 adults (>16 years)] and 974 disease controls. All patients and controls underwent duodenal biopsy. IgA anti-tTG and IgG anti-DGP assays were from Thermo Fisher and Inova.Likelihood ratios for CD markedly increased with double positivity and increasing antibody levels of IgA anti-tTG and IgG anti-DGP. Patients with double positivity and high antibody levels (>3 times, >10 times ULN) had a high probability for having CD (likelihood ratio ≥649 for >3 times ULN and ∞ for >10 times ULN). The fraction of CD patients with double positivity and high antibody levels was 59%–67% (depending on the assay) for >3 ULN and 33%–36% (depending on the assay) for >10 ULN, respectively. This fraction was significantly higher in children with CD than in adults.Combining IgG anti-DGP with IgA anti-tTG and defining thresholds for antibody levels improves the serologic diagnosis of CD.

Serologic Diagnosis of Celiac Disease

2019 ◽  
Vol 48 (2) ◽  
pp. 307-317 ◽  
Author(s):  
Aaron Lerner ◽  
Ajay Ramesh ◽  
Torsten Matthias
Keyword(s):  
Celiac Disease ◽  
Serologic Diagnosis

Tissue transglutaminase, the celiac disease autoantigen, preferentially generates antigenic neoepitopes in γ and γ but not in α gliadins

2001 ◽  
Vol 120 (5) ◽  
pp. A684-A684
Author(s):  
D TRAPP ◽  
W DIETERICH ◽  
H WIESER ◽  
M LEIDENBERGER ◽  
D SEILMEIER ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Tissue Transglutaminase

IgA-antitissue transglutaminase: Sensitivity and specificity for diagnosing Celiac Disease

2001 ◽  
Vol 120 (5) ◽  
pp. A395-A395
Author(s):  
J WEST ◽  
A LLOYD ◽  
P HILL ◽  
G HOLMES
Keyword(s):  
Celiac Disease ◽  
Sensitivity And Specificity

High prevalence of celiac disease in Migraine

2001 ◽  
Vol 120 (5) ◽  
pp. A393-A393
Author(s):  
M GABRIELLI ◽  
C PADALINO ◽  
E LEO ◽  
S DANESE ◽  
G FIORE ◽  
...  
Keyword(s):  
Celiac Disease ◽  
High Prevalence
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