Paola Fonio

Azienda Ospedaliero Universitaria Maggiore della Carità, Novara, Piedmont, Italy

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Publications (3)6.85 Total impact

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    ABSTRACT: The aim of this study was to evaluate performance of serum antibodies against deamidated gliadin peptides (a-DGPs) in detecting compliance with gluten-free diet (GFD) in children with celiac disease (CD). Serum samples were collected the same day of endoscopy in 95 children with CD and 106 controls. We preliminarily calculated the cutoff of a-DGP immunoglobulin A (IgA) and a-DGP IgA+G in our population by receiver operating characteristic (ROC) curves. Of 95 children with CD, 28 were studied during the first year after GFD introduction, with interview and serum collection every 3 months. In addition, serum samples were collected in 106 children with CD on GFD for more than 1 year (range 1-14). In both groups of children with CD on GFD, we compared a-DGP IgA and IgA+G performance in monitoring compliance with GFD with anti-tissue transglutaminase antibodies (anti-tTG) IgA and anti-gliadin antibody (AGA) IgA. The cutoff resulted in 13.1 arbitrary units (AU) for a-DGP IgA (sensitivity 87.4, 95% confidence interval [CI] 79%-92%, specificity 97.2, 95% CI 92%-99%) and 16.5 for a-DGP IgA+G (sensitivity 94.7, 95% CI 88%-98%, specificity 89.6, 95% CI 84%-95%). In the first year of GFD, at 6 to 8 months prevalence of positive a-DGPs was significantly higher in partially versus strictly compliant children, and at 9 to 12 months only prevalence of positive a-DGP IgA+G remained significantly higher. Moreover, at 9 to 12 months sensitivity to detect transgressions to GFD was 44% for a-DGP IgA and 100% for a-DGP IgA+G (P = 0.03). In the 106 children on GFD for more than 1 year, sensitivity to detect transgressions to GFD was 60% for a-DGP IgA and 76% for a-DGP IgA+G. Anti-tTG IgA and AGA IgA sensitivity was much lower (24% and 4%, respectively). The 4 tests showed comparable high specificity. Both a-DGPs showed higher sensitivity than anti-tTG IgA and AGA IgA in monitoring compliance with GFD, but a-DGP IgA+G seemed to perform better. a-DGPs did not outperform anti-tTG IgA for CD screening.
    Journal of pediatric gastroenterology and nutrition 07/2011; 53(1):55-60. DOI:10.1097/MPG.0b013e3182145511 · 2.63 Impact Factor
  • E Caristo · E Tognato · G Di Dio · A Rapa · P Fonio ·
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    ABSTRACT: In the last few years we noted an increasing number of children with celiac disease with negative serum anti-gliadin antibodies (AGA) a useful serologic test to monitor compliance to gluten-free diet. The aim of this study was to verify diagnostic accuracy of AGA and compare clinical characteristics of AGA-negative with AGA-positive celiac children. The authors analyzed serum of AGA-negative celiac children with 3 Elisa kits, and compared clinical and anthropometric data of AGA-negative with AGA-positive celiac children. Celiac disease was diagnosed with small bowel biopsy, and total IgA were determined. Children with IgA-deficiency were excluded. When retested with two other commercial kits, serum values of AGA-negative children were confirmed in all but one. In the last 14 years a diagnosis of celiac disease was performed in 166 children, in 56 of them (33.7%) antigliadin antibodies were negative. Preva-lence of AGA-negative celiac children increased significantly in the last years (from 23% before 2002 to 39.8% after 2002, P=0.04). AGA-negative children were significantly older (7.8 years vs. 3.7 years, P=0.0007) they complained more frequently of abdominal pain (55%, vs. 25,4% P=0.04) and less frequently of anaemia (8% vs. 24.5% P=0.012) and were less likely to have a classical celiac triad (5.3 vs. 22%, P=0.004) than AGA-positive children. Serum AGA seem no longer useful for monitoring compliance to gluten-free diet. In children where AGA are negative at diagnosis, when the child eats a normal amount of gluten, they are going to remain negative even after poor compliance.
    Minerva pediatrica 04/2010; 62(2):119-23. · 0.43 Impact Factor
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    ABSTRACT: To validate the (13)C-urea-breath-test (UBT) and stool antigen test (HpSA) in children aged 5 years or younger, against invasive histologic study and rapid-urease-testing or culture. On all consecutive children aged 5 years or younger undergoing endoscopy in 1 single center during the last 7.5 years, UBT and HpSA were performed. Of a total of 184 children (median age 2.2 years, range 0.2-5.5), 30 were Helicobacter pylori-positive (16.3%). Sensitivity and specificity of UBT were 93.3% (95%CI 77.9%-99.2%) and 95.5% (90.9-98.2), with a cutoff of 5 per thousand, but specificity increased to 98.1% (94.4%-99.6%) with a cutoff of 8 per thousand. Sensitivity and specificity of HpSA were 93.3% (77.9%-99.2%) and 98.7% (95.4%-99.8%). Accuracy of noninvasive tests in our single-center study were satisfactory: specificity of UBT improved with a cutoff at 8%, and sensitivity of HpSA was high when determined locally without transportation after long or inadequate storage that could impair results.
    Journal of Pediatrics 01/2007; 149(6):817-21. DOI:10.1016/j.jpeds.2006.08.047 · 3.79 Impact Factor