RT Journal Article
SR Electronic
T1 Validation of point-of-care testing for coeliac disease in children in a tertiary hospital in north India
JF Archives of Disease in Childhood
JO Arch Dis Child
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP 1004
OP 1008
DO 10.1136/archdischild-2013-305567
VO 99
IS 11
A1 Singh, Prashant
A1 Wadhwa, Nitya
A1 Chaturvedi, Mona K
A1 Bhatia, Vidyut
A1 Saini, Savita
A1 Tandon, Nikhil
A1 Makharia, Govind K
A1 Maki, Markku
A1 Not, Tarcisio
A1 Phillips, Alan
A1 Bhatnagar, Shinjini
YR 2014
UL http://adc.bmj.com/content/99/11/1004.abstract
AB Objective Some of the conventional serological tests for coeliac disease (CD) are expensive, time-consuming and not readily available in developing countries, leading to a delay in diagnosis. Recently, point-of-care tests (POCT) have been manufactured and tested in Europe but have not been validated in our setting. We therefore aimed to study the diagnostic accuracy of the POCT ‘Biocard’ test in diagnosing CD in Indian children. Design Cross-sectional study. Setting Tertiary care centre in north India. Patients Children, aged 2–18 years, with chronic diarrhoea, short stature or refractory anaemia underwent serological testing for CD with antiendomysial antibodies (AEA), antitissue transglutaminase (tTG) antibodies and Biocard test followed by duodenal biopsy irrespective of serological results. CD was diagnosed with positive AEA and duodenal biopsy showing >grade 2 changes using modified Marsh criteria. Those who were both AEA negative and had normal histology were considered CD negative. Results Of 319 children who underwent the serological testing, 170 agreed for biopsy. Of these, 110 were diagnosed with CD and 30 were found to be CD negative. Remaining 30 had discordant AEA and histology results and were not included in analysis. Biocard test agreed with 92/110 positive and 27/30 negative diagnoses based on reference tests (83.6% sensitivity and 90% specificity). tTG was found to be 93.8% sensitive and 96.4% specific. Conclusions We successfully validated the POCT for CD in our setting. It could be used to increase case detection rates in developing countries with a large undiagnosed CD burden.