MAKING A CORRECT DIAGNOSIS ON FINGERTIPS

Key words: Coeliac disease, IgA anti-h-tTG antibodies, Whole blood, IgA deficienc

It is hard to imagine that a simple test of “self help diagnostic” can be helpful for diagnosing coeliac disease using only a few drops of whole blood. But today this text exists and it can be purchased at any pharmacy. This test, called Xeliac test or Eu-tTG Quick test, is based on detection of IgA anti-h-tTG antibodies in a few drops of whole blood and it is performable in 5-6 minutes. This test has incredible theoretical basis, but the literature on its possible practical use is still poor.

THE RAPID TEST FOR COELIAC DISEASE IN THE EXPERIENCE OF ITS INVENTORS

Key words: Coeliac disease, Tissue transglutaminase, Rapid test

Coeliac disease is an autoimmune enteropathy triggered by the ingestion of gluten in genetically susceptible individuals. The diagnosis is suspected upon the presence of typical autoantibodies in the serum of patients, and confirmed by intestinal biopsy. For a long time, these serologic tests were only performable in laboratories. The availability of a rapid test, that can be performed on a large scale, in any setting has significantly simplified the diagnosis of coeliac disease. The Authors of the article explain the way the test functions, the clinical implications and the literature that proved the test as an effective addition to the previously available diagnostic tools for the diagnosis of coeliac disease.

RAPID TEST FOR COELIAC DISEASE: SCREENING OR CASE FINDING?

Key words: Coeliac disease, Rapid test, Screening, Case finding

The Authors report an epidemiologic prospective screening study that aimed at evaluating the clinical prevalence of coeliac disease in Emilia Romagna region using the rapid test for coeliac disease (Eu-tTG Quick). 4,414 asymptomatic patients, recruited in the elementary schools of the region, were involved in the study. So far, data regarding 1,074 patients are available. The Authors discuss the usefulness of the rapid coeliac test in identifying asymptomatic patients and the organization issue that arose during the study. Giving the high number of asymptomatic patients, the Authors suggest that a screening approach should be preferred to the case finding in coeliac disease.

SEARCHING FOR COELIAC DISEASE USING THE RAPID TEST: THE INDIAN EXPERIENCE

Coeliac disease was first reported in India in the 1960s. Over the last decade, coeliac disease has been increasingly recognized and is considered to have a significant presence in the country. The Authors report from an on-going study where in a series of 231 children with chronic diarrhoea, abdominal distension, and growth failure the rapid test (Biocard POC) was performed. The results were compared to anti-endomisium (EMA) antibodies and duodenal biopsy. The preliminary analysis of the study so far shows that the Biocard POC test has good specificity but it has a high false negative rate. However, it does appear that POC-testing is a useful adjunct to formal diagnostic testing, although it must be used in a setting that has access to specialized facilities where the diagnosis can be confirmed