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R Troncone

Publications and source records attributed to R Troncone.

94 records · Page 6Linked to original sources
PubMedDate not supplied

Discriminant analysis for the diagnosis of childhood celiac disease.

A new statistical approach to the analysis of laboratory data has been introduced to optimize the use of absorption tests and gliadin antibody measurement for the diagnosis of childhood celiac disease. Serum antigliadin antibodies, as well as blood xylose, iron, and tryglycerides after oral load, were evaluated in 40 celiac children and 43 age-matched patients affected by other gastrointestinal diseases. Each test evaluated individually gave a considerable rate of false-positive and false-negative results. Discriminant coefficients produced for each test were used to compute a score that allowed correct classification of 99% of patients; 2.3% of false-positive and no false-negative results were recorded. This approach improves significantly the overall sensitivity and specificity for celiac disease of these laboratory tests and we propose its use for screening patients to be submitted to jejunal biopsy.

Adolescent↗
PubMedDate not supplied

Quantitative antigliadin antibody measurement in clinical practice: an Italian multicentre study. SIGEP Working Group on Quantitative AGA Standardization.

BACKGROUND: The determination of class G and A serum antigliadin antibodies remains one of the most widely used screening tests for coeliac disease. The results from different laboratories are not always comparable, on account of changes in the technique and the different ways of expressing the results. AIMS: To: a) evaluate the physiological variation of serum antigliadin antibodies expressed in ng/ml, and b) establish the cut-off of quantitative antigliadin antibodies. PATIENTS: Patients were 127 individuals with active coeliac disease. Controls were 395 non-coeliac subjects (198 females and 197 males) aged 6 months to 45 years (median age: 4.9 years). METHODS: Antigliadin antibody enriched samples were obtained by affinity chromatography. The concentration of the eluted antigliadin antibodies was evaluated by nephelometry and enzyme-linked immunosorbent assay to establish a primary standard. An enzyme-linked immunosorbent assay for antigliadin antibody determination was run according to standard procedures. RESULTS: In controls, IgG-antigliadin antibody showed high variability in the 50th-90th centile range that peaked during the second year of life while IgA-antigliadin antibodies showed a lower variability and a less pronounced trend to decreasing values with age. A certain degree of overlapping between controls and coeliac patients was seen for both IgA- and IgG-antigliadin antibodies. The receiver operating characteristic analysis showed that the best discrimination was achieved by a cut-off of 8-10 ng/ml for IgA-antigliadin antibodies and 150-200 ng/ml for IgG-antigliadin antibodies. CONCLUSIONS: Antigliadin antibody concentration is not normally distributed and changes with age in non-coeliac subjects. The receiver operating characteristic analysis is a valuable tool for fixing the antigliadin antibody cut-offs between control and diseased individuals. The diagnosis of coeliac disease should always be confirmed by intestinal biopsy.

Adolescent↗
PubMedDate not supplied

Effects of small amounts of gluten in the diet of coeliac patients.

A diet excluding wheat, oats, rye and barley is the cornerstone of the treatment of coeliac patients. Such a gluten-free diet (GFD) is recommended irrespective of the presence of symptoms. Maintenance of a strict GFD is not a simple matter, as small amounts of gluten capable of causing relapse have been identified in several previously unsuspected sources, thanks to the recent availability of sensitive detection assays. To date there is no definition as to what amount of gluten in the diet might be tolerable. Compliance to the GFD is a problem, particularly in certain groups of patients (e.g. adolescents). Small amounts of gluten in the diet often do not cause clinical symptoms, nor increased serum levels of antigliadin antibody, nor gross changes of the jejunal histology; nevertheless, they seem to be able to activate mucosal cell-mediated immunity. This finding represents a warning in view of the recently reported protective effect of GFD against malignancies. In conclusion, all present evidences give strong support for advising all patients to adhere to a strict GFD for life.

Adolescent↗