Erratum

Abstract

The publisher would like to draw the reader's attention to an error in the following Supplement:The abstract below should be included in J. Gastroenterol. Hepatol. 2014, Volume 29, Supplement S2.Can coeliac disease be diagnosed solely based on serology?Anja Klasen1, Cheng Hiang Lee1,2, Andrew Williams3,4, Kevin J Gaskin1,21James Fairfax Institute of Paediatric Nutrition, The University of Sydney, NSW, Australia.2Department of Gastroenterology, The Children's Hospital at Westmead, NSW, Australia.3Department of Immunology, The Children's Hospital at Westmead, NSW, Australia.4Central Clinical School, The University of Sydney, NSW, Australia.Background and Aim: Histological examination of duodenal biopsies is the gold standard for the diagnosis of coeliac disease. However, recent European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) guidelines suggested that potentially children with tissue transglutaminase antibodies 10 times greater than upper limit of normal (ULN), could be diagnosed with coeliac disease without a biopsy. The aim of this study is to evaluate the specificity of locally available coeliac serology tests and the applicability of ESPGHAN guidelines in our clinical practice.Methods: We collected serological data from 734 paediatric patients who had duodenal biopsy for suspected coeliac disease from 2004 to 2013. During the study period, 3 different assays for tissue transglutaminase IgA (tTG IgA) were used in our institution. We also investigated the assays for combined tTG IgA/IgG and deamidated antigliadin IgG (DGP). The specificity and sensitivity of these assays were calculated based on duodenal biopsy results as gold standard. In the evaluation of tTG IgA patients under the age of 2 or with IgA deficiency were excluded.Results: 497 patients had biopsy proven coeliac disease, 237 patients were normal. Using tTG IgA at 4 times ULN as cut‐off value, retrospectively applied to the study cohort, potentially 138 patients (36.9% of all patients tested for tTg IgA) could be diagnosed without a biopsy, with only one false positive result (0.3%). Similarly DGP levels 3.65 times ULN had a specificity of 100%; 30 patients (12.3%) could be diagnosed without having a biopsy. The specificity of the tTG IgA/IgG at 12.5 times ULN (highest definable value of the assay) was only 80.3%.Conclusions: tTG IgA and DGP at 4 and 3.7 times ULN respectively had a very high specificity for coeliac disease. We propose that in a selected group of patients with high pre‐test probability, the diagnosis of coeliac disease without the need to undertake a duodenal biopsy could be considered.