Serological markers and celiac disease: a new diagnostic approach?
We analyze the diagnostic efficacy of two celiac disease serological markers: anti-gliadin (IgA and IgG class) and anti-endomysium IgA-class (EmA-IgA) antibodies applied to 336 serum samples from celiac patients on both gluten-challenge and gluten-free diets, and a control group. The anti-gliadin and anti-endomysium antibodies levels were significantly higher among the gluten-consuming celiac patients than in the other groups. The greatest efficacy in diagnosing celiac disease was achieved in the Ema-IgA class test. The IgA-class anti-gliadin antibodies proved to be more specific, with a higher positive test predictive value than the IgG-class anti-gliadin antibodies, whereas the latter proved to be more sensitive, with a higher negative test predictive value than those of the IgA-class anti-gliadin antibodies. Our results also demonstrate that the simultaneous assessment of anti-gliadin IgA- and IgG-class antibodies constitutes a valid test in selecting patients suspected of having celiac disease. In turn the EmA-IgA antibodies constitute a confirmative test for indication of an intestinal biopsy.
General Hospital, Department of Pediatrics and Clinical Analysis Section of Gastroenterology, Valencia, Spain.
M
M
Calabuig
R
R
Torregosa
P
P
Polo
L
L
Tuset
C
C
Tomás
V
V
Alvarez
A
A
Garcia-Vila
J
J
Brines
P
P
Vilar
C
C
Farré
D000293:Adolescent; D000906:Antibodies / Q000032:analysis*; D015415:Biomarkers / Q000097:blood; D002446:Celiac Disease / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D004406:Dysgammaglobulinemia / Q000175:diagnosis; D004797:Enzyme-Linked Immunosorbent Assay / Q000592:standards; D005260:Female; D005455:Fluorescent Antibody Technique / Q000592:standards; D005903:Gliadin / Q000276:immunology*; D006801:Humans; D017098:IgA Deficiency; D007070:Immunoglobulin A / Q000032:analysis; D007074:Immunoglobulin G / Q000032:analysis; D007223:Infant; D008297:Male; D010940:Plant Proteins / Q000276:immunology*; D012680:Sensitivity and Specificity
D000906:Antibodies; D015415:Biomarkers; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D010940:Plant Proteins; D005903:Gliadin