A new, simple and noninvasive method has been developed to determine whether a child aged two to four years of age suffers from celiac disease (CD) or not, without the necessity of a blood extraction. Silent celiac disease goes unnoticed to the eyes of the doctor because it presents minor symptoms, imperceptible even for the patient.

Celiac disease is a systemic disease caused by a permanent intolerance to gluten, which can be found in wheat, barley and rye, and it affects people with genetic predisposition. The symptoms are intestinal malabsorption, abdominal distension, diarrhea, abdominal pain, and extra-digestive including skin problems, joint pain, cephalalgia.

Scientists working in collaboration with those at the Virgen de las Nieves University Hospital (Granada, Spain) recruited 198 children aged two to four years, mean age 32.3 ± 9.2 months, and 53% were males. CD prevalence according to the serological tests was 3% (CI 95%, 1.4%–6.4%). Biopsies were used to confirm the diagnosis in all suspected cases. Cross-sectional study was carried in a sample population of children who were apparently healthy subjects from the same metropolitan area.

The team collected clinical, anthropometric, analytical, and serological variables. They also tested for anti-gliadin immunoglobulin A (IgA) and anti-transglutaminase IgG and IgA using a rapid immunochromatographic test CD1WB and CD2WB (Operon; Zaragoza, Spain). The tests detected six celiac children among the 198 who participated in the study, which is a very high prevalence of 3%, higher than the European mean. All of them presented no symptoms at all, or minor imperceptible symptoms which did not make their parents consult a pediatrician.

The sensitivity and negative predictive value of the CD2WB immunochromatographic test strip were 100% and 1, respectively. The sensitivity of CD1WB was 16.6% and its specificity was high at 89.1%. A positive outcome of the test will require further confirmation via blood extraction and assessment of the disease antibodies via other methods, but a negative outcome will allow the dismissal, with certainty, of being affected by the disease. The method does not require experienced personnel, although it has to be interpreted by health professionals, is quick as it only takes10 minutes, economic at EUR 10 to 12 per device, and, most important of all in the case of infant population, this method is less invasive than a blood extraction. The study was published originally published in September 2015 in the journal Pediatric Research.

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Virgen de las Nieves University Hospital
Operon