Accuracy of Screening Tests for Celiac Disease in Asymptomatic Patients With Type 1 Diabetes.

Gould, Michelle J; Mahmud, Farid H; Clarke, Antoine B M; McDonald, Charlotte; Saibil, Fred; Punthakee, Zubin; Marcon, Margaret A · Am J Gastroenterol · 2021

cross_sectional · Level IV

Where this comes from

Abstract

To evaluate the diagnostic performance of celiac serologic tests in asymptomatic patients with type 1 diabetes (T1D). Patients with T1D asymptomatic for celiac disease were prospectively screened with immunoglobulin A anti-tissue transglutaminase. Test characteristics were calculated and optimal cutoffs for a positive screen determined. Two thousand three hundred fifty-three patients were screened and 101 proceeded to biopsy. The positive predictive value of immunoglobulin A anti-tissue transglutaminase at the assay referenced upper limit of normal (30CU) was 85.9%, and the sensitivity and specificity were 100% and 38%, respectively. Thresholds extrapolated from the general population for the diagnostic evaluation of celiac disease are not suitable for use in asymptomatic T1D patients. Population-specific screening cutoffs are required.

Medical subject headings