Rua Bruno Filgueira, 369 - Cj 1205, CEP 80240-220, Curitiba, Paraná, Brazil.
World J Gastroenterol. 2009 Sep 21;15(35):4423-8. doi: 10.3748/wjg.15.4423.
To evaluate the effectiveness of a rapid and easy fingertip whole blood point-of-care test for celiac disease (CD) case finding and diet monitoring.
Three hundred individuals, 206 females (68.7%) and 94 males (31.3%), were submitted to a rapid and easy immunoglobulin-A-class fingertip whole blood point-of-care test in the doctor's office in order to make immediate clinical decisions: 13 healthy controls, 6 with CD suspicion, 46 treated celiacs, 84 relatives of the celiac patients, 69 patients with dyspepsia, 64 with irritable bowel syndrome (IBS), 8 with Crohn's disease and 9 with other causes of diarrhea.
Upper gastrointestinal endoscopy with duodenal biopsies was performed in patients with CD suspicion and in individuals with positive test outcome: in 83.3% (5/6) of the patients with CD suspicion, in 100% of the patients that admitted gluten-free diet transgressions (6/6), in 3.8% of first-degree relatives (3/79) and in 2.9% of patients with dyspepsia (2/69). In all these individuals duodenal biopsies confirmed CD (Marsh's histological classification). The studied test showed good correlation with serologic antibodies, endoscopic and histological findings.
The point-of-care test was as reliable as conventional serological tests in detecting CD cases and in CD diet monitoring.
评估一种快速简便的指尖全血即时检验用于乳糜泻(CD)病例发现和饮食监测的效果。
300 名个体,206 名女性(68.7%)和 94 名男性(31.3%)在医生办公室接受了快速简便的 IgA 类指尖全血即时检验,以便立即做出临床决策:13 名健康对照者、6 名 CD 疑似患者、46 名接受治疗的乳糜泻患者、84 名乳糜泻患者亲属、69 名消化不良患者、64 名肠易激综合征(IBS)患者、8 名克罗恩病患者和 9 名其他原因腹泻患者。
对 CD 疑似患者和检验结果阳性的个体进行了上消化道内镜检查和十二指肠活检:6 名 CD 疑似患者中有 5 名(83.3%)、6 名承认无麸质饮食违规的患者中均(100%)、79 名一级亲属中有 3 名(3.8%)和 69 名消化不良患者中有 2 名(2.9%)发现了 CD。所有这些个体的十二指肠活检均证实了 CD(Marsh 组织学分类)。研究中的检测与血清抗体、内镜和组织学发现具有良好的相关性。
该即时检验与传统血清学检测在发现 CD 病例和监测 CD 饮食方面同样可靠。