engleski

Celiac serologic testing -whether it became fashionable?

Background: The number of requests for celiac serologic testing continuously increases for elders partly due to the worldwide gluten-free lifestyle trends. Aim: To evaluate demographic characteristic of patients, the requestor, compliance to diagnostic algorithm and anti- tTG- IgA positivity rate in 2015 in comparison to 2011. Materials and Methods: Data collected in period from 2nd November 2014 to 2nd November 2015 were compared with 2011. To confirm the increasing anti-tTG-IgA request trend we compare it with ANA requests. Anti- tTg-IgA and anti-DGP- IgG was performed by ELISA (Euroimmun) or FEIA (Thermo Scientific). Results: Increased number of anti-tTG-IgA requests (1566, +35°/o) in selected period were confirmed in comparison with 2011 with minor decrease for ANA requests, concomitantly. Rate of outpatients was significantly higher in 2015 compared with 2011 (44°/o vs. 34°/o, P<0.0001) and inpatients lower (56°/o vs. 66°/o, P=0.0011). There were 55°/o of patients >18 yrs in 2015 in comparison with 41°/o in 2011 (P<0.0001). Positivity rate of anti-tTG- IgA in 2015 was 2.0°/o in comparison to 5.4°/o in 2011(P<0.0001) but without difference between low- and high-positivity rates. Anti-DGP-IgG testing were requested for 175 patients only, parallel with anti-tTG-IgA in 162/175. Anti­ DGP- IgG positivity rate was 2, 2°/o (2 high- positive anti-DGP-IgG/anti-tTG­ IgA, 2 low- positive anti- DGP-IgG). Conclusions: Results are in accordance with our presumption of randomly requested celiac serologic testing. Non-compliance with diagnostic test algorithm with anti-tTG-IgA request only, without testing for total IgA or anti­ DGP-IgG was noticed, mostly for non- pediatric patients. In the report we include interpretative comment regarding importance of total IgA for a correct interpretation of anti- tTG-IgA results.

serologic testing; autoimmunity; celiac disease

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