1. POINT-OF-CARE TEST FOR DIAGNOSIS OF CELIAC DISEASE Workshop MEDICEL The Mediterranean Network for Celiac Disease III Progress Meeting PastaTrend, BolognaFiere Bologna, April 5 th 2011

2. Celiac disease: diagnosis POINT OF CARE TEST Celiac autoantibodies can be detected with a simple IgA self-tG antibodies Contrary to conventional serum EMA and tTG-ab tests, self tTG required no external purified or recombinant celiac antigen (endogenous erythrocyte self tTG) POCT is very easy to perform, does not need specialized healtcare professional Result are available in 5 minutes

4. Coeliac disease case finding and diet monitoring by point-of-care testing I. R. Korponay-Szabo´ et al Results (1) Positivity of the whole blood rapid test, serum IgA endomysial antibody (EMA) and serum IgA transglutaminase antibody (TG2-Ab) test in untreated coeliac disease patients and controls

5. Self transglutaminase-based rapid coeliac disease antibody detection by a lateral flow method T. Raivio et al Results (2) Sensitivity, specificity, positive and negative predictive value and efficiency of the IgA-class rapid whole blood test, serum tissue transglutaminase antibody (tTG-ab) and serum endomysium (EMA) tests on stored samples in the laboratory. Comparison of on site rapid whole blood test results and serum endomysial antibody (EMA) and tissue transglutaminase antibody (tTG-ab) test results when patients under coeliac disease suspicion were investigated prospectively

6. Celiac disease:Test setting Laboratory test DIAGNOSIS ? POCT DIAGNOSIS (suspected) Hospital MD Nurse

7. POINT OF CARE TEST: HOW (1) Identify peripheral villages with: 1. At least 5.000 inhabitants 2. Collaborative Health Centre/GP/Nurse 3. Possibility to store serum 4. Possibility to communicate with a referral centre Features of the patients to enlist: 1. Age: 1 year – 15 years 2.Growth disorders and/or 3.Persistent diarrhoea, vomiting, abdominal discomfort, anaemia and/or 4.Misery Collect results in a logbook and send serum to a referral centre to confirm the diagnosis IDD.BirthD.VisitSymp1Symp2Symp3Test 00111/02/0923/11/11DiarrhoeaVomiting- - 00205/07/0824/11/11Abd. Disc.DiarrhoeaAnaemia +

8. POINT OF CARE TEST: HOW (2) If +, collect blood Centrifuge with an hand centrifuge and store serum Send serum to referral centre Diagnosis and diet POCT