Diagnostic value of serologic tests in celiac screening

Area of Science:

• Pediatric Gastroenterology
• Immunology
• Diagnostic Medicine

Background:

• Celiac disease is a malabsorption syndrome causing growth and development issues in children.
• Diagnosis relies on clinical findings, serology, biopsy, and treatment response.
• Serologic tests are valuable, non-invasive screening tools, though their diagnostic utility varies.

Purpose of the Study:

• To evaluate the diagnostic value of celiac serologic tests in children under 15.
• To compare the effectiveness of anti-endomysial antibody (EMA), anti-gliadin antibody (AGA), and tissue transglutaminase antibody (tTG) tests.

Main Methods:

• A two-year study at Al-Zahra hospital involving children suspected of celiac disease.
• Evaluation of serologic tests (EMA, AGA, tTG) and clinical symptoms in children undergoing duodenal biopsy.
• Statistical analysis using descriptive statistics, chi-square, and Fisher's exact tests.

Main Results:

• Tissue transglutaminase antibody (tTG) demonstrated the highest diagnostic value (37.5% positive predictive value).
• Anti-endomysial antibody (EMA) had a 20.0% positive predictive value.
• Anti-gliadin antibody (AGA) showed a 11.6% positive predictive value.
• No significant correlation was found between common gastrointestinal symptoms and celiac disease.

Conclusions:

• Tissue transglutaminase antibody (tTG) is the most reliable screening test for pediatric celiac disease.
• Anti-gliadin antibody (AGA) and anti-endomysial antibody (EMA) have limited diagnostic value for celiac disease.
• Gastrointestinal symptoms like vomiting, diarrhea, and failure to thrive were not significantly correlated with celiac disease in this study.