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...
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MDPI AG
2021-12-01
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| author | Giulia N. Catassi Alfredo Pulvirenti Chiara Monachesi Carlo Catassi Elena Lionetti |
| author_facet | Giulia N. Catassi Alfredo Pulvirenti Chiara Monachesi Carlo Catassi Elena Lionetti |
| author_sort | Giulia N. Catassi |
| collection | DOAJ |
| 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); <i>p</i> < 0.001) while the sensitivity of DGP IgG was higher without reaching statistical significance (OR: 0.6 (95% CI, 0.24–1.51); <i>p</i> = 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. |
| first_indexed | 2024-03-10T03:27:46Z |
| format | Article |
| id | doaj.art-3c864b1880bd4d93b18e28333e55ac99 |
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| issn | 2072-6643 |
| language | English |
| last_indexed | 2024-03-10T03:27:46Z |
| publishDate | 2021-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Nutrients |
| spelling | doaj.art-3c864b1880bd4d93b18e28333e55ac992023-11-23T12:02:41ZengMDPI AGNutrients2072-66432021-12-01141710.3390/nu14010007Diagnostic 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-AnalysisGiulia N. Catassi0Alfredo Pulvirenti1Chiara Monachesi2Carlo Catassi3Elena Lionetti4Department of Pediatrics, University La Sapienza, 00185 Rome, ItalyDepartment of Mathematics and Bioinformatics, University of Catania, 95125 Catania, ItalyCeliac Disease Research Laboratory, Marche Polytechnic University, 60123 Ancona, ItalyDepartment of Pediatrics, Marche Polytechnic University, 60123 Ancona, ItalyDepartment of Pediatrics, Marche Polytechnic University, 60123 Ancona, ItalyThe 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); <i>p</i> < 0.001) while the sensitivity of DGP IgG was higher without reaching statistical significance (OR: 0.6 (95% CI, 0.24–1.51); <i>p</i> = 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.https://www.mdpi.com/2072-6643/14/1/7anti-deamidated gliadin peptide antibodiesanti-transglutaminase antibodiesceliac diseasechildren |
| spellingShingle | Giulia N. Catassi Alfredo Pulvirenti Chiara Monachesi Carlo Catassi Elena Lionetti 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 Nutrients anti-deamidated gliadin peptide antibodies anti-transglutaminase antibodies celiac disease children |
| 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 | anti-deamidated gliadin peptide antibodies anti-transglutaminase antibodies celiac disease children |
| url | https://www.mdpi.com/2072-6643/14/1/7 |
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