Speeding up coeliac disease diagnosis in the developing countries

S. Crovella, L. Brandao, R. Guimaraes, J. L. de Lima Filho, L. C. Arraes, A. Ventura, T. Not

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Anti-transglutaminase antibodies are highly predictive markers of active coeliac disease. Because limited facilities are available for routine use of anti-transglutaminase antibodies assays in developing countries, a simple, economical immunological test would represent a great step forward in the screening of coeliac disease. Aim: We determined the prevalence of coeliac disease in two different populations living in an urban area and in a sub-urban impoverished area of Recife (Brazil), using two rapid tests based on detection of anti-transglutaminase antibodies in serum and in one drop of whole blood. Methods: Whole-blood and serum samples from 1074 individuals were analysed by the two rapid tests; 580 subjects were university students and 494 subjects were coming from sub-urban impoverished areas, characterized by the endemic presence of filariasis. The positive subjects were evaluated by anti-tranglutaminase enzyme linked immunosorbent assay (ELISA) assay, the coeliac disease-related HLA DQ2/8 and intestinal biopsy. Results: Both rapid assays were positive in 25/1074 subjects, but only 9/25 (4/4 in urban areas, specificity 100%; 5/21 in poor areas, specificity 76%) were confirmed positive by ELISA assay. The nine subjects testing positive for HLA DQ2 and the intestinal biopsy showed the typical coeliac disease lesions (coeliac disease-prevalence: 0.84%, 9/1074); seven coeliacs were asymptomatic and two presented recurrent abdominal pain. Conclusions: The rapid assays were accurate in finding new coeliacs at a remarkably low cost. We are convinced that this new way of testing for coeliac disease can be successfully used by non-specialized personnel in daily practice in developing countries.

Original languageEnglish
Pages (from-to)900-902
Number of pages3
JournalDigestive and Liver Disease
Volume39
Issue number10
DOIs
Publication statusPublished - Oct 2007

Keywords

  • Anti-transglutaminase antibodies rapid assays
  • Coeliac disease
  • Developing countries

ASJC Scopus subject areas

  • Gastroenterology

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