ISG Winter Meeting 2024

Poster Presentations
Third Award

Dr Ananya Singh
The National Centre for Paediatric Gastroenterology, Children’s Health Ireland, Dublin / University College Dublin

TBA (24W186)

Prospective and Retrospective Cohort Study of Diagnostic Data in Paediatric Coeliac Disease Patients

Author(s)

A. Singh1,2, S. Aljuwaie1,3, R. Hack-Mendes1, S. Cooper1, A. Dominik1, S. Quinn1, S. Hussey1-3

Department(s)/Institutions

1. The National Centre for Paediatric Gastroenterology, Children’s Health Ireland, Dublin. 2. University College Dublin, Dublin. 3. Royal College of Surgeons of Ireland.

Introduction

Coeliac Disease (CD) may present at any age-group and is a common indication for endoscopic assessment.

Aims/Background

The aim of the study was to explore the demographic and diagnostic factors in paediatric patients with suspected CD.

Method

Patients were identified from the prospective SUCCEEDS study (Science Underlying CoeliaC Evolution: Explanations, Discoveries, Solutions), from November 2022- January 2024. Retrospective data from 2018-2022 was collated and data analysed collectively. Serum levels of tissue transglutaminase IgA antibodies (tTg-IgA) were recorded in patients suspected of having CD, and diagnosis was confirmed through duodenal biopsy (Marsh Grade >2). The performance of tTG serology thresholds were assessed for diagnostic accuracy. Data were analysed using JAMOVI statistical software.

Results

A total of 883 patients were identified from the combined SUCCEEDS (prospective cohort) and retrospective cohorts, of which 79% were diagnosed with CD. Using serology results relative to the upper range of normal (ULN), values 2.1-4x ULN had the highest sensitivity (90%), whereas values >10x ULN had the highest specificity (81%) and positive predictive value (90%). Younden’s index was highest (0.29) at a threshold of 4.1-6x ULN with an area under receiving operating curve of 0.69. There were no significant predictors of CD, including sex, birth history, breastfeeding history, home dwelling location, exposure to farm animals, and CD family history (X2 p >0.05).

Conclusions

Our real world data suggest Irish coeliac serology testing performance is less than that quoted in published literature. Further research including analysis of follow up data and recruitment of patients is necessary to interpret the data more accurately.

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