Brief Articles
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Sep 21, 2009; 15(35): 4423-4428
Published online Sep 21, 2009. doi: 10.3748/wjg.15.4423
A Brazilian experience of the self transglutaminase-based test for celiac disease case finding and diet monitoring
Lorete Maria da Silva Kotze, Ana Paula Brambila Rodrigues, Luiz Roberto Kotze, Renato Mitsunori Nisihara
Lorete Maria da Silva Kotze, Ana Paula Brambila Rodrigues, Luiz Roberto Kotze, Gastroenterology and Endoscopy Services, Cajuru Hospital, Pontifical Catholic University of Paraná, CEP 80240-220, Curitiba, Paraná, Brazil
Renato Mitsunori Nisihara, Evangelical University and Laboratory of Immunopathology, Clinical Hospital, Federal University of Paraná, CEP 80240-220, Curitiba, Paraná, Brazil
Author contributions: Kotze LM performed clinical trials and the majority of experiments; Brambila Rodrigues AP performed tests and endoscopic procedures; Kotze LR performed histological evaluations; Nisihara RM performed laboratory antibody determinations; All the authors participated in the trial, designed the study, wrote and revised the manuscript.
Supported by Pontifical Catholic University of Paraná
Correspondence to: Lorete Maria da Silva Kotze, MD, PhD, Professor, FACG, Rua Bruno Filgueira, 369 - Cj 1205, CEP 80240-220, Curitiba, Paraná, Brazil. loretekotze@hotmail.com
Telephone: +55-41-33361088 Fax: +55-41-33361088
Received: July 3, 2009
Revised: August 25, 2009
Accepted: September 1, 2009
Published online: September 21, 2009
Abstract

AIM: To evaluate the effectiveness of a rapid and easy fingertip whole blood point-of-care test for celiac disease (CD) case finding and diet monitoring.

METHODS: Three hundred individuals, 206 females (68.7%) and 94 males (31.3%), were submitted to a rapid and easy immunoglobulin-A-class fingertip whole blood point-of-care test in the doctor’s office in order to make immediate clinical decisions: 13 healthy controls, 6 with CD suspicion, 46 treated celiacs, 84 relatives of the celiac patients, 69 patients with dyspepsia, 64 with irritable bowel syndrome (IBS), 8 with Crohn’s disease and 9 with other causes of diarrhea.

RESULTS: Upper gastrointestinal endoscopy with duodenal biopsies was performed in patients with CD suspicion and in individuals with positive test outcome: in 83.3% (5/6) of the patients with CD suspicion, in 100% of the patients that admitted gluten-free diet transgressions (6/6), in 3.8% of first-degree relatives (3/79) and in 2.9% of patients with dyspepsia (2/69). In all these individuals duodenal biopsies confirmed CD (Marsh’s histological classification). The studied test showed good correlation with serologic antibodies, endoscopic and histological findings.

CONCLUSION: The point-of-care test was as reliable as conventional serological tests in detecting CD cases and in CD diet monitoring.

Keywords: Celiac disease; Gluten; Relatives; Dyspepsia; Diarrhea