Anti-endomysium and anti-gliadin antibodies as serological markers for coeliac disease in childhood: a clinical study to develop a practical routine.
Anti-gliadin and anti-endomysium antibodies were analyzed in 174 children with suspected or verified coeliac disease with the aim of developing a practical routine. The biopsy was performed without knowledge of the antibody levels. To screen for coeliac disease is children younger than 2 years, we suggest the use of IgA anti-gliadin antibodies, giving a sensitivity of 100% and a specificity of 86%. In older children both tests should be used in parallel, i.e. a biopsy should be performed if at least one of the tests is positive, giving a sensitivity of 98% and a specificity of 81%. To avoid unnecessary biopsy before mucosal relapse can be demonstrated during gluten challenge in a child without clinical symptoms, we suggest that the tests are used as serial testing, i.e. a biopsy should be performed if both tests are positive.
Grodzinsky
E
E
Department of Clinical Immunology, University Hospital of Linköping, Sweden.
Jansson
G
G
Skogh
T
T
Stenhammar
L
L
Fälth-Magnusson
K
K
D000293:Adolescent; D001323:Autoantibodies / Q000032:analysis*; D015415:Biomarkers; D001706:Biopsy; D002446:Celiac Disease / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005903:Gliadin / Q000276:immunology*; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis*; D007223:Infant; D007413:Intestinal Mucosa / Q000473:pathology; D007583:Jejunum / Q000473:pathology; D008297:Male; D009210:Myofibrils / Q000276:immunology*; D012680:Sensitivity and Specificity
D001323:Autoantibodies; D015415:Biomarkers; D007070:Immunoglobulin A; D005903:Gliadin