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POINT-OF-CARE TEST FOR DIAGNOSIS OF CELIAC DISEASE
Workshop MEDICELThe Mediterranean Network for Celiac Disease
III Progress MeetingPastaTrend, BolognaFiere
Bologna, April 5th 2011
Celiac disease: diagnosisPOINT OF CARE TEST
• Celiac autoantibodies can be detected with a simple IgA self-tG antibodies
• Contrary to conventional serum EMA and tTG-ab tests, self tTG required no external purified or recombinant celiac antigen (endogenous erythrocyte self tTG)
•POCT is very easy to perform, does not need specialized healtcare professional
• Result are available in 5 minutes
Coeliac disease case finding and diet monitoring by point-of-care testingI. R. Korponay-Szabo´ et al
Results (1)
Positivity of the whole blood rapid test, serum IgA endomysial antibody (EMA) and serum IgA transglutaminase antibody (TG2-Ab) test in untreated coeliac disease patients and controls
Self transglutaminase-based rapid coeliac disease antibody detection by a lateral flow methodT. Raivio et al
Results (2)Sensitivity, specificity, positive and negative predictive value and efficiency of the IgA-class rapid whole blood test, serum tissue transglutaminase antibody (tTG-ab) and serum endomysium (EMA) tests on stored samples in the laboratory.
Comparison of on site rapid whole blood test results and serum endomysial antibody (EMA) and tissue transglutaminase antibody (tTG-ab) test results when patients under coeliac disease suspicion were investigated prospectively
Celiac disease:Test setting
Laboratory test
DIAGNOSIS
?POCT
DIAGNOSIS (suspected)
Hospital
MDMDNurse
POINT OF CARE TEST: HOW (1)• Identify peripheral villages with:1. At least 5.000 inhabitants2. Collaborative Health Centre/GP/Nurse3. Possibility to store serum4. Possibility to communicate with a referral centre
• Features of the patients to enlist:1. Age: 1 year – 15 years2. Growth disorders and/or3. Persistent diarrhoea, vomiting, abdominal discomfort, anaemia and/or4. Misery
• Collect results in a logbook and send serum to a referral centre to confirm the diagnosisID D.Birth D.Visit Symp1 Symp2 Symp3 Test
001 11/02/09 23/11/11 Diarrhoea Vomiting - -002 05/07/08 24/11/11 Abd. Disc. Diarrhoea Anaemia +
POINT OF CARE TEST: HOW (2)
If +, collect blood
Centrifuge with an hand
centrifuge and store
serum
Send serum to referral
centre
Diagnosis and diet
POCT