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1.
J Pediatr ; 137(3): 356-60, 2000 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-10969260

RESUMO

OBJECTIVES: The transglutaminase (TG) antibody test is accurate in identifying celiac disease in symptomatic children. We sought to determine the positive predictive value of this test in asymptomatic children at genetic risk for celiac disease. STUDY DESIGN: Asymptomatic children with a genetic risk for celiac disease were studied to investigate the relationships between TG antibody titer, small bowel histology, growth, and clinical features. Small bowel biopsy histology was graded by using the system of Marsh. RESULTS: Of 30 children with a positive TG antibody test result, 21 (70%) had definite (Marsh score 2 or 3) and 4 (13%) had possible (Marsh score 1) biopsy evidence of celiac disease. TG antibody titer correlated with Marsh score (r = 0.569, P <.01). There was an inverse correlation between Marsh score and height z score (r = -0.361, P =. 05). CONCLUSIONS: In this group of asymptomatic children screened because of a genetic risk, TG antibodies have a positive predictive value of 70% to 83% for biopsy evidence of celiac disease and may identify children before clinical features of celiac disease develop.


Assuntos
Autoanticorpos/análise , Doença Celíaca/enzimologia , Doença Celíaca/genética , Predisposição Genética para Doença , Transglutaminases/imunologia , Adolescente , Doença Celíaca/diagnóstico , Criança , Pré-Escolar , Feminino , Humanos , Intestino Delgado/enzimologia , Intestino Delgado/imunologia , Intestino Delgado/patologia , Masculino , Valor Preditivo dos Testes , Radioimunoensaio , Estatísticas não Paramétricas
2.
J Pediatr ; 137(3): 361-6, 2000 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-10969261

RESUMO

OBJECTIVE: To determine whether consumption of oats is safe in children with newly diagnosed celiac disease who are starting a gluten-free diet. STUDY DESIGN: We conducted a self-controlled, open-label, 6-month trial of a commercial oat breakfast cereal product. Primary outcome variables were small bowel histomorphology and anti-tissue transglutaminase IgA antibody titer. RESULTS: The 10 children who completed the study were 6.8 +/- 4.0 (mean +/- SD) years of age and 5 were male. Over 6.6 +/- 0.7 months, they consumed 24 grams of oat cereal per day, or 1.2 +/- 0.9 g/kg/d. Compared with start of study, at completion there was a significant decrease in biopsy score (P <.01), intra-epithelial lymphocyte count (P <.005), anti-tissue transglutaminase IgA antibody titer (P <.01), and number of symptoms (P <.01). CONCLUSIONS: We conclude that consumption of a commercially available oat cereal product for 6 months is safe for children with celiac disease beginning a gluten-free diet. Studies are needed to determine the long-term safety of including oat cereal in the gluten-free diet.


Assuntos
Avena , Doença Celíaca/dietoterapia , Doença Celíaca/diagnóstico , Doença Celíaca/imunologia , Doença Celíaca/patologia , Criança , Feminino , Glutens , Humanos , Imunoglobulina A/análise , Intestino Delgado/enzimologia , Intestino Delgado/imunologia , Intestino Delgado/patologia , Contagem de Linfócitos , Masculino , Radioimunoensaio , Estatísticas não Paramétricas , Transglutaminases/imunologia
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