Objective: The high prevalence of celiac disease (CD) prompted us to evaluate a new, noninvasive disease screening strategy. The aim was to identify CD in 6- to 8-year-old children for a timely diagnosis, start gluten-free diet (GFD) in compliant subjects, achieve the growth target, and prevent CD complications. Methods: Five thousand subjects were invited to participate in the study. Four thousand forty-eight saliva samples were tested for anti-tissue transglutaminase (tTG) immunoglobulin (Ig) A using a fluid-phase radioimmunoprecipitation method. Positive children were tested for serum radioimmunoassay tTG IgA, enzyme-linked immunosorbent assay tTG IgA, and anti-endomysium IgA. Children confirmed as positive by serum assays underwent endoscopy with duodenal biopsies and, at the diagnosis of CD, were suggested to start GFD. Results: Consent was obtained from 4242 parents (84.8%) for the screening to be performed, and adequate saliva samples were collected from 4048 children (95.4%). Thirty-two children were found to be salivary tTG IgA positive and 9 with borderline autoantibody levels. Thirty-one of the 32 and 3 of the 9 subjects were also serum positive. Twenty-eight children showed villous atrophy when undergoing intestinal biopsy, whereas 1 had Marsh 1 lesions; 3 children were suggested to start GFD without performing endoscopy. CD prevalence in the population investigated (including 19 CD known cases) was 1.16%. The ratio between screening-detected patients and those diagnosed before the screening was 3:2. The ratio between symptomatic and asymptomatic patients was 1:1.6. Conclusions: We demonstrated that it is possible to perform a powerful, simple, well-accepted, and sensitive CD screening using saliva. Until now, the compliance with GFD in children with CD has been optimal.

First Salivary Screening of Celiac Disease by Detection of Anti-transglutaminase Autoantibody Radioimmunoassay in 5000 Italian Primary Schoolchildren / Bonamico, Margherita; Nenna, Raffaella; Monica, Montuori; Luparia, RITA PIA LARA; Turchetti, Arianna; Mennini, Maurizio; Lucantoni, Federica; Donata, Masotti; Magliocca, Fabio Massimo; Culasso, Franco; Tiberti, Claudio. - In: JOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION. - ISSN 0277-2116. - STAMPA. - 52:1(2011), pp. 17-20. [10.1097/mpg.0b013e3181e6f2d0]

First Salivary Screening of Celiac Disease by Detection of Anti-transglutaminase Autoantibody Radioimmunoassay in 5000 Italian Primary Schoolchildren

BONAMICO, Margherita;NENNA, RAFFAELLA;LUPARIA, RITA PIA LARA;TURCHETTI, ARIANNA;MENNINI, MAURIZIO;LUCANTONI, Federica;MAGLIOCCA, Fabio Massimo;CULASSO, Franco;TIBERTI, Claudio
2011

Abstract

Objective: The high prevalence of celiac disease (CD) prompted us to evaluate a new, noninvasive disease screening strategy. The aim was to identify CD in 6- to 8-year-old children for a timely diagnosis, start gluten-free diet (GFD) in compliant subjects, achieve the growth target, and prevent CD complications. Methods: Five thousand subjects were invited to participate in the study. Four thousand forty-eight saliva samples were tested for anti-tissue transglutaminase (tTG) immunoglobulin (Ig) A using a fluid-phase radioimmunoprecipitation method. Positive children were tested for serum radioimmunoassay tTG IgA, enzyme-linked immunosorbent assay tTG IgA, and anti-endomysium IgA. Children confirmed as positive by serum assays underwent endoscopy with duodenal biopsies and, at the diagnosis of CD, were suggested to start GFD. Results: Consent was obtained from 4242 parents (84.8%) for the screening to be performed, and adequate saliva samples were collected from 4048 children (95.4%). Thirty-two children were found to be salivary tTG IgA positive and 9 with borderline autoantibody levels. Thirty-one of the 32 and 3 of the 9 subjects were also serum positive. Twenty-eight children showed villous atrophy when undergoing intestinal biopsy, whereas 1 had Marsh 1 lesions; 3 children were suggested to start GFD without performing endoscopy. CD prevalence in the population investigated (including 19 CD known cases) was 1.16%. The ratio between screening-detected patients and those diagnosed before the screening was 3:2. The ratio between symptomatic and asymptomatic patients was 1:1.6. Conclusions: We demonstrated that it is possible to perform a powerful, simple, well-accepted, and sensitive CD screening using saliva. Until now, the compliance with GFD in children with CD has been optimal.
screening; ria anti-transglutaminase autoantibodies; schoolchildren; saliva; celiac disease
01 Pubblicazione su rivista::01a Articolo in rivista
First Salivary Screening of Celiac Disease by Detection of Anti-transglutaminase Autoantibody Radioimmunoassay in 5000 Italian Primary Schoolchildren / Bonamico, Margherita; Nenna, Raffaella; Monica, Montuori; Luparia, RITA PIA LARA; Turchetti, Arianna; Mennini, Maurizio; Lucantoni, Federica; Donata, Masotti; Magliocca, Fabio Massimo; Culasso, Franco; Tiberti, Claudio. - In: JOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION. - ISSN 0277-2116. - STAMPA. - 52:1(2011), pp. 17-20. [10.1097/mpg.0b013e3181e6f2d0]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/229232
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