Abstract
Coeliac disease (CD) screening has progressed rapidly with tissue transglutaminase (TTG), the screening tool of choice. However, TTG may be unreliable in young children and advances in CD etiology understanding have seen improvements in antiโgliadin (AGA) assay technology. The aim of this study was to investigate the utility of an updated and refined AGA (Neogliadin) assay for CD screening in children with gastrointestinal symptoms. Children attending the Sydney Children's Hospital, Randwick, with gastrointestinal symptoms had sera collected and assayed by Neogliadin and commercial TTG assays in addition to the usual clinical workโup. One hundred and fifteen children were recruited in which 32 were diagnosed with CD. AGAโIgA screening by Neogliadin showed improved sensitivity (83%) and specificity (91%) but did not eclipse the sensitivity (93%) and specificity (90%) of TTGโIgA screening. In the children diagnosed with CD, 7 were identified as younger than 5 years of age with 4/7 AGAโIgA positive, 5/7 AGAโIgG positive, and 6/7 TTGโIgA positive. The updated Neogliadin IgA assay does not improve on the accuracy achieved by TTG screening. TTG appears to be a suitable screening tool for children younger than 5 years of age although this preliminary finding requires confirmation. J. Clin. Lab. Anal. 22:327โ333, 2008. ยฉ 2008 WileyโLiss, Inc.