scholarly journals Non-Biopsy Serology-Based Diagnosis of Celiac Disease in Adults Is Accurate with Different Commercial Kits and Pre-Test Probabilities

Nutrients ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2736
Author(s):  
Venla Ylönen ◽  
Katri Lindfors ◽  
Marleena Repo ◽  
Heini Huhtala ◽  
Valma Fuchs ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Transglutaminase 2 ◽  
Clinical Suspicion ◽  
Family Risk ◽  
Serum Samples ◽  
Clinical Cohort ◽  
The Family ◽  
Endomysial Antibodies ◽  
Commercial Kits ◽  
Diagnostic Investigations

Non-biopsy diagnosis of celiac disease is possible in children with anti-transglutaminase 2 antibodies (TGA) > 10× the upper limit of normal (ULN) and positive anti-endomysial antibodies (EMA). Similar criteria have been suggested for adults, but evidence with different TGA assays is scarce. We compared the performance of four TGA tests in the diagnosis of celiac disease in cohorts with diverse pre-test probabilities. Serum samples from 836 adults with either clinical suspicion or family risk of celiac disease were tested with four commercial TGA assays, EmA and celiac disease-associated genetics. The diagnosis was set based on duodenal lesion or, in some cases, using special methods. 137 (57%) patients with clinical suspicion and 85 (14%) of those with family risk had celiac disease. Positive predictive value (PPV) for 10×ULN was 100% in each TGA test. The first non-diagnostic investigations were encountered with ULN 1.0×–5.1× in the clinical cohort and 1.3×–4.9× in the family cohort, respectively. Using the assays’ own cut-offs (1×ULN) the PPVs ranged 84–100%. Serology-based diagnosis of celiac disease was accurate in adults using different commercial kits and pre-test probabilities using 10×ULN. The results also suggest that the ULN threshold for biopsy-omitting approach could be lower.

Cerebellar atrophy supporting diagnosis of alcohol dependence: A case report

2016 ◽  
Vol 33 (S1) ◽  
pp. S311-S311
Author(s):  
F. Pavez Reyes ◽  
M. Sánchez ◽  
E. Moral ◽  
M. Terradillos ◽  
N. López ◽  
...  
Keyword(s):  
Case Report ◽  
Alcohol Dependence ◽  
Cerebellar Atrophy ◽  
Clinical Suspicion ◽  
Gamma Glutamyl Transferase ◽  
The Family ◽  
Other Information ◽  
Diagnostic Hypothesis ◽  
Competing Interest ◽  
Glutamyl Transferase

Chronic use of alcohol is a known cause of cerebellar atrophy. This finding could be a valuable diagnosis support when there are not other information sources. In this case report, we describe a 65-year-old male patient who was referred from primary care to specialized consultation because a depressive syndrome it was unresponsive to treatment with desvenlafaxine and lorazepam. In psychopathological exploration we found overvalued ideas of suffering some kind of injury and damage by the family, which oriented the diagnostic hypothesis of delusional disorder with secondary mood symptoms, although the clinical suspicion of abuse of alcohol was proposed as a differential diagnosis. The continuing minimization and denial of consumption by the patient as well as their reluctance to incorporate an external informant made that the workup was a key element to elucidate the diagnosis. We found a discrete increase in transaminases, gamma glutamyl transferase and alkaline phosphatase. Magnetic resonance imaging showed cerebellar atrophy (vermian and, in a lesser extent, in both hemispheres). Once the patient was confronted with these results, he agreed to disclose his problem, which fulfilled alcohol dependence criteria. After that, he accepted to initiate treatment and detoxification in a specialized unity.ConclusionsAlthough psychiatric diagnosis is based on the clinical features and the exclusion of associated medical conditions, in this case the workup provided support to our clinical suspicion, favouring recognition of the problem and willingness to treatment by the patient.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Familial multiple sclerosis: literature review, own data analysis

2020 ◽  
Vol 18 (5) ◽  
pp. 69-75
Author(s):  
Z. A. GONCHAROVA ◽  
◽  
Yu. Yu. POGREBNOVA ◽  
Yu. V. TRINITATSKIY ◽  
T. V. SYCHEVA ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Data Analysis ◽  
Average Rate ◽  
Family Risk ◽  
Risk Of Recurrence ◽  
Mcdonald Criteria ◽  
Rostov Region ◽  
The Family ◽  
Course Material ◽  
Student’S T

To optimize the management of patients with familial multiple sclerosis (MS) by identifying the clinical and epidemiological features of the disease course. Material and methods. The object of the study was 2253 patients with clinically reliable MS according to McDonald criteria (2010, 2017) living in the Rostov region. Statistical analysis of the results was processed using the application package Excel, Statistics 13.0 MacOSX (Apple Inc., USA). Data analysis was carried out using the 𝜒2 criterion. The significance of differences was assessed using the Student’s t-test; the differences were considered statistically significant at p < 0,05. Results. 108 family cases were identified in the analyzed population of the Rostov region (2 or more MS patients in a family). The overall risk of recurrence among the population of the Rostov region was 4,8%, the family risk of recurrence was 2,7%. The M:F ratio is 1:3,5, the age of debut in the first generation exceeded the age of debut in subsequent generations on average by 5,9 (0,1) years. The duration of the first remission in the family MS group (2,4 (1,0) years), and the average rate of progression was 0.5 (0,1) points per year. Conclusions. In most families, the «ancestor» of MS was a woman, this fact indicates a possible role of mitochondria in the pathogenesis of the disease. Genealogical analysis of the evidence in favor of non-mendelian types of inheritance. A burdened family history is an unfavorable prognostic factor for the course of MS, which should be taken into account when determining the patient’s management tactics.

scholarly journals Lack of evidence of porcine reproductive and respiratory syndrome virus (PRRSV) infection in domestic swine in Brazil

2004 ◽  
Vol 34 (2) ◽  
pp. 449-455 ◽  
Author(s):  
Janice Reis Ciacci-Zanella ◽  
Cristiano Trombetta ◽  
Ildara Vargas ◽  
Denise Euclydes Mariano da Costa
Keyword(s):  
Genetic Material ◽  
Elisa Test ◽  
Respiratory Syndrome Virus ◽  
Rt Pcr ◽  
Serum Samples ◽  
Viral Isolation ◽  
Culture Cells ◽  
Commercial Kits ◽  
Swine Herds ◽  
Domestic Swine

This report describes the first prevalence of antibodies and experimental inoculation of suspected samples of porcine reproductive and respiratory syndrome virus (PRRSV) from ELISA positive pigs from swine herds in Brazil. Based on the hypothesis that this agent is present in swine herds worldwide, the objective of this work was to establish a diagnostic methodology and to investigate the occurrence of PRRSV in Brazilian swine herds. Fifty-four swine herds, the total number which imported genetic material (live pigs or swine semen) from countries where PRRS was endemic from 1990 to December 2000, from eight Brazilian States all included in this study. The sampling used was such as to detect a prevalence of infection of 5%, with a confidence level of 95%. A total of 3785 serum samples were tested for PRRSV antibodies by ELISA. Following the ELISA test, which was performed with two different commercial kits, all serum positive pigs were retested, examined and additional materials were collected. Viral isolation in permissive tissue culture cells and swine bioassays were performed. Additionally, reverse transcriptase polymerase chain reaction (RT-PCR) and nested RT-PCR were also performed. We could not demonstrate the presence of PRRSV or RNA of PRRSV by viral isolation or RT-PCR (or nested RT-PCR), respectively in all of the analyzed samples. Furthermore, the pigs inoculated with PRRSV suspicion samples did not seroconvert nor produce characteristic PRRS lesions in the swine bioassay. Thus, our results indicate no evidence of PRRSV in the samples analyzed from swine herds in this study.

scholarly journals Family risk as adjunct for organizing the demand for oral health service in the Family Health Strategy

2015 ◽  
Vol 44 (2) ◽  
pp. 85-91 ◽  
Author(s):  
Henri Menezes Kobayashi ◽  
Antonio Carlos Pereira ◽  
Marcelo de Castro Meneghim ◽  
Rívea Inês Ferreira ◽  
Glaucia Maria Bovi Ambrosano
Keyword(s):  
Primary Care ◽  
Oral Health ◽  
Multinomial Logistic Regression ◽  
Family Health ◽  
Health Conditions ◽  
Family Risk ◽  
Treatment Needs ◽  
Health Strategy ◽  
The Family ◽  
Family Health Strategy

Introduction One of the main problems of the public health services, in which the family oral health team is included, is access by users to dental treatment in primary care, with particular reference to caries disease. Objective The aim of this study was to evaluate the relationship between family risk, for prioritization of home visits and oral health conditions, with a view to providing evidence about the first indicator for organizing the demand for oral health in the Family Health Strategy (FHS). Method The application of family health is based on Form A of the primary care information database SIAB ("Sistema de Informação de Atenção Básica"), used for registering families with the FHS. Eleven dentists examined the oral health conditions of 1165 persons (608 from 12 to 19 years; and 557 from 35 to 44 years of age), classifying them into six codes from A to F. Multinomial logistic regression was used (α=0.05) to analyze the association between family risk variables and oral health situation. Result There was significant association between family risk and presence of caries disease with treatment needs (OR: 2.08, p<0.0001). Conclusion Persons who have family risk would have twice as much chance of presenting caries disease in comparison with those without risk, corroborating the relevance of this element in organizing the demand for oral health.

scholarly journals Circulating miRNAs as Potential Biomarkers for Celiac Disease Development

2021 ◽  
Vol 12 ◽  
Author(s):  
Ineke L. Tan ◽  
Rodrigo Coutinho de Almeida ◽  
Rutger Modderman ◽  
Anna Stachurska ◽  
Jackie Dekens ◽  
...  
Keyword(s):  
Celiac Disease ◽  
European Population ◽  
Circulating Mirnas ◽  
Serum Samples ◽  
Short Rnas ◽  
Individual Mirnas ◽  
Mirna Sequencing ◽  
Diagnostic Biopsy ◽  
Transcriptional Gene Regulation ◽  
Meta Analyses

Background &amp; AimsCeliac disease (CeD), an immune-mediated disease with enteropathy triggered by gluten, affects ~1% of the general European population. Currently, there are no biomarkers to predict CeD development. MicroRNAs (miRNAs) are short RNAs involved in post-transcriptional gene regulation, and certain disease- and stage-specific miRNA profiles have been found previously. We aimed to investigate whether circulating miRNAs can predict the development of CeD.MethodsUsing next-generation miRNA-sequencing, we determined miRNAs in &gt;200 serum samples from 53 participants of the PreventCD study, of whom 33 developed CeD during follow-up. Following study inclusion at 3 months of age, samples were drawn at predefined ages, diagnosis (first anti-transglutaminase antibody (TGA) positivity or diagnostic biopsy) and after the start of a gluten-free diet (GFD). This allowed identification of circulating miRNAs that are deregulated before TGA positivity. For validation of the biomarkers for CeD and GFD response, two additional cohorts were included in subsequent meta-analyses. Additionally, miRNAs were measured in duodenal biopsies in a case-control cohort.Results53 circulating miRNAs were increased (27) or decreased (26) in CeD versus controls. We assessed specific trends in these individual miRNAs in the PreventCD cohort by grouping the pre-diagnostic samples of the CeD patients (all had negative TGA) by how close to seroconversion (first sample positive TGA) the samples were taken. 8/53 miRNAs differed significantly between controls and samples taken &lt;1 year before TGA positivity: miR-21-3p, miR-374a-5p, 144-3p, miR-500a-3p, miR-486-3p let-7d-3p, let-7e-5p and miR-3605-3p. 6/26 downregulated miRNAs reconstituted upon GFD, including miR-150-5p/-3p, whereas no upregulated miRNAs were downregulated upon GFD. 15/53 biomarker candidates also differed between CeD biopsies and controls, with a concordant direction, indicating that these circulating miRNAs might originate from the intestine.ConclusionsWe identified 53 circulating miRNAs that are potential early biomarkers for CeD, of which several can be detected more than a year before TGA positivity and some start to normalize upon GFD.

Commercial kits for 1,25-dihydroxyvitamin D compared with a liquid-chromatographic assay

1993 ◽  
Vol 39 (6) ◽  
pp. 1086-1088 ◽  
Author(s):  
S Bertelloni ◽  
G I Baroncelli ◽  
U Benedetti ◽  
G Franchi ◽  
G Saggese
Keyword(s):  
Healthy Subjects ◽  
Clinical Work ◽  
Comparison Method ◽  
Serum Concentrations ◽  
Serum Samples ◽  
Dihydroxyvitamin D ◽  
1,25 Dihydroxyvitamin D ◽  
Liquid Chromatographic Method ◽  
Commercial Kits ◽  
Liquid Chromatographic

Abstract Three commercially available kits for 1,25-dihydroxyvitamin D [1,25(OH)2D] determination were compared with a liquid-chromatographic method. Serum samples were analyzed for 1,25(OH)2D from 70 healthy subjects (age 2.2-17.5 years; 35 males, 35 females), some (n = 5) given orally high vitamin D3 doses. In addition, 1,25(OH)2D was measured in 28 patients with untreated diseases associated with low (n = 16) or high (n = 12) serum concentrations of the hormone. The results showed that the commercial kits were sufficiently accurate with respect to the comparison method and suitable for routine clinical work.

scholarly journals New Automated Immunoassay Measuring Immunoglobulin A Antigliadin Antibodies for Prediction of Celiac Disease in Childhood

2001 ◽  
Vol 8 (3) ◽  
pp. 564-570 ◽  
Author(s):  
E. Grodzinsky ◽  
A. Ivarsson ◽  
P. Juto ◽  
P. Olcén ◽  
K. Fälth-Magnusson ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Characteristic Curve ◽  
Immunoglobulin A ◽  
Total Serum ◽  
Small Intestinal Mucosa ◽  
Serum Samples ◽  
Serological Tests ◽  
Population Prevalence ◽  
Serum Iga ◽  
Antigliadin Antibodies

ABSTRACT The prevalence of celiac disease (CD) in Sweden is about 4 cases per 1,000 people. Screening for CD with serological tests indicates similar high prevalences in many other countries. Between 1 November 1992 and 30 April 1995, 133 children (9 months to 16.7 years of age) with suspected CD were studied. The predictive value (PV) of immunoglobulin A antigliadin antibodies (IgA-AGA) in the serum as assayed with two new commercial automated immunoassays—the Pharmacia CAP System Gliadin IgA FEIA (CAP) and the UNICAP-100 (UNICAP)—and with three “in-house” methods was evaluated using assessment of the small intestinal mucosa morphology as the “gold standard.” All serum samples were analyzed for total serum IgA. At presentation the diagnostic sensitivities and specificities of the different tests varied from 0.72 to 0.88 and 0.67 to 0.87, respectively. All methods showed a higher sensitivity for CD in younger children. The area under each assay's receiver operating characteristic curve was calculated and varied between 0.82 and 0.89. The positive and negative PVs for the CAP and UNICAP, which were assays with a high sensitivity and a high specificity, respectively, were estimated. In the clinically selected population (prevalence of CD, 1 in 3) the positive PV was about 55%, and in the general population (prevalence, 1 in 250) it was about 1%. The negative PVs for both CAP and UNICAP were close to 100%; thus, when the AGA test was negative, the risk for CD was small. Interestingly, five children had serum IgA levels below the detection limit (<0.07 g/liter) when on a gluten-free diet, whereas they had normal levels at the time of the first biopsy. In conclusion, the automated immunoassays—based on ImmunoCAP technology—for analysis of IgA-AGA had a reliability comparable to that of the in-house methods.

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