Celiac Disease Clinical Trial
Official title:
Choosing a Preferred Serology Kit for Screening and Diagnosis of Celiac Disease
The investigators will perform prospective observational multicenter study which includes children with suspicion of CD who referred to gastroscopy and intestinal biopsies (study group) and children without suspicion of CD who underwent gastroscopy for other reasons. The investigators will compare sensitivity, specificity and predictive values of several serological kits of TG2 (tissue transglutaminase) (Bioplex 2200, Bioflash, Phadia 250, Liason-XL, Orgentec Alergia and Eurospital) compared with definitive diagnosis of CD according to histological findings.
Small bowel biopsies have so far been considered as the reference standard for the diagnosis
of Celiac disease (CD). However, during the last decades evidence has accumulated on the
diagnostic value of specific CD antibodies and has increasingly been used for diagnostic
purposes. At the same time, the leading role of histology for the diagnosis of CD has been
questioned for several reasons: histological findings are not specific for CD, lesions may be
patchy and can occur in the duodenal bulb only and interpretation depends on preparation of
the tissue and is prone to a high inter-observer variability. The diagnosis of CD may then
depend not only on the results of small bowel biopsies, but also on information from clinical
data and on results from specific CD antibody testing. ESPGHAN (European Society of
Gastroenterology, Hepatology and Nutrition) guidelines for the diagnosis of CD which was
recently published enabled diagnosis of CD based on classical symptoms and high titre levels
(>10 times upper limit of normal) of tissue transglutaminase (TG2) and positive Endomysial
Anti bodies (EMA) in separate blood samples.
Due to these facts, it is important to use serological kit for TG2 with high specificity and
sensitivity. The aim of this study is to assess in a prospective study the kit with the
highest sensitivity and specificity among patients with suspected CD.
The investigators will perform prospective observational multicenter study which includes
children with suspicion of CD who referred to gastroscopy and intestinal biopsies (study
group) and children without suspicion of CD who underwent gastroscopy for other reasons. The
investigators will compare sensitivity, specificity and predictive values of several
serological kits of TG2 (Bioplex 2200, Bioflash, Phadia 250, Liason-XL, Orgentec Alergia and
Eurospital) compared with definitive diagnosis of CD according to histological findings.
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