Panacea Index Logo

Command Palette

Search for a command to run...

Influence of the 2012 European Guidelines in Diagnosis and Follow-up of Coeliac Children With Selective IgA Deficiency.

Journal of pediatric gastroenterology and nutrition
July 1, 2020
Raquel Vecino López et al. (6 authors)
Journal ArticleMulticenter StudyHuman Study
Study Details

Study Goal

The researchers aimed to evaluate diagnostic criteria for coeliac disease in children with selective IgA deficiency and assess the impact of a gluten-free diet on serological markers.

Results Summary

The study found that despite good dietary adherence and symptom remission, 52% of children remained ATG IgG-positive after 2 years on a gluten-free diet. Diagnostic criteria varied, with IgG serology often used equivalently to IgA isotype, even when not addressed in guidelines.

Population

Children under 15 years with selective IgA deficiency diagnosed with coeliac disease.

Effective Dosage

Not specified

Duration

2 years

Interactions

None mentioned

Extracted Claims (2)
InterventionDirectionEndpointPopulationDosageImpactClaim #
gluten-free diet
no change
ATG IgG serology
children with selective IgA deficiency and coeliac disease
52%
remained positive
#1
gluten-free diet
decrease
symptoms
children with selective IgA deficiency and coeliac disease
-
remission
#2
Abstract

OBJECTIVES: The aim of the study was to describe diagnostic criteria used in children with coeliac disease (CD) and selective IgA deficiency; to determine if the publication of the 2012 ESPGHAN criteria prompted any changes; to evaluate the evolution of serological markers. METHODS: Multicenter, retrospective, descriptive study of a cohort of children under 15 years with selective IgA deficiency diagnosed with CD (January 2006 to December 2016). Demographic, clinical, genetic, histological and IgG-based antibodies were collected at diagnosis and follow-up. RESULTS: Eighty-six children were included, 60 diagnosed after the guide. Two groups were established: G1 (n = 63) and G2 (n = 23) with or without diagnostic biopsy respectively. In G1: 87.3% were symptomatic, 87.3% had human leukocyte antigan (HLA) DQ2/DQ8 typing (all positive), all had IgG serology positive (71.5% ATG, 35% EMA, 19% DPG, 9.5% AGA), and all had villous atrophy (Marsh-Oberhuber 2-3). Follow-up data were available in 58 children, 34 after 2 years on a gluten-free diet. Fifty-two percentage remained ATG IgG-positive despite good dietary adherence and symptom remission. Regarding G2: all were diagnosed post-2012, had typical symptoms, HLA DQ2/DQ8 positive and ATG IgG × 10 ULN. Additionally, EMA IgG was performed in 14 (60%), all positive. CONCLUSIONS: In our cohort of children with selective IgA deficiency and diagnosed with CD, children without a diagnostic biopsy suggests that IgG serology was considered the equivalent as IgA isotype, even when this is not addressed in the aforementioned guidelines. Great heterogeneity was observed in the IgG serology used at diagnosis. After 2 years of a gluten-free diet, half of children remained with a positive serology.

Medical Subject Headings (MeSH)
AutoantibodiesBiopsyCeliac DiseaseChildFollow-Up StudiesHumansIgA DeficiencyImmunoglobulin ARetrospective StudiesTransglutaminases
Study Links
Quality Scores
SafetyNot Assessed
Efficacy70/10
Quality75/10
Citation Metrics
Total Citations12
Citations/Year2.4
Relative Citation Ratio1.12
NIH Percentile54.5%
Research Impact Scores
APT Score0.75
Weight Score2.25
Normalized Score0.63
Related Supplements