POINT-OF-CARE TEST FOR DIAGNOSIS OF CELIAC DISEASE

Workshop MEDICELThe Mediterranean Network for Celiac Disease

III Progress MeetingPastaTrend, BolognaFiere

Bologna, April 5th 2011

Celiac disease: diagnosisPOINT OF CARE TEST

• Celiac autoantibodies can be detected with a simple IgA self-tG antibodies

• Contrary to conventional serum EMA and tTG-ab tests, self tTG required no external purified or recombinant celiac antigen (endogenous erythrocyte self tTG)

•POCT is very easy to perform, does not need specialized healtcare professional

• Result are available in 5 minutes

Coeliac disease case finding and diet monitoring by point-of-care testingI. R. Korponay-Szabo´ et al

Results (1)

Positivity of the whole blood rapid test, serum IgA endomysial antibody (EMA) and serum IgA transglutaminase antibody (TG2-Ab) test in untreated coeliac disease patients and controls

Self transglutaminase-based rapid coeliac disease antibody detection by a lateral flow methodT. Raivio et al

Results (2)Sensitivity, specificity, positive and negative predictive value and efficiency of the IgA-class rapid whole blood test, serum tissue transglutaminase antibody (tTG-ab) and serum endomysium (EMA) tests on stored samples in the laboratory.

Comparison of on site rapid whole blood test results and serum endomysial antibody (EMA) and tissue transglutaminase antibody (tTG-ab) test results when patients under coeliac disease suspicion were investigated prospectively

Celiac disease:Test setting

Laboratory test

DIAGNOSIS

?POCT

DIAGNOSIS (suspected)

Hospital

MDMDNurse

POINT OF CARE TEST: HOW (1)• Identify peripheral villages with:1. At least 5.000 inhabitants2. Collaborative Health Centre/GP/Nurse3. Possibility to store serum4. Possibility to communicate with a referral centre

• Features of the patients to enlist:1. Age: 1 year – 15 years2. Growth disorders and/or3. Persistent diarrhoea, vomiting, abdominal discomfort, anaemia and/or4. Misery

• Collect results in a logbook and send serum to a referral centre to confirm the diagnosisID D.Birth D.Visit Symp1 Symp2 Symp3 Test

001 11/02/09 23/11/11 Diarrhoea Vomiting - -002 05/07/08 24/11/11 Abd. Disc. Diarrhoea Anaemia +

POINT OF CARE TEST: HOW (2)

If +, collect blood

Centrifuge with an hand

centrifuge and store

serum

Send serum to referral

centre

Diagnosis and diet

POCT