Endomysial antibody screening in children.
It has been suggested that endomysial antibodies are specific markers for coeliac disease. In a 13-month study, we examined the usefulness of screening for these antibodies in the diagnosis of coeliac disease in children. Twenty-one of 223 (9.4%) serum samples [or 17 of 192 (9%) children undergoing investigation for GI disorders] were found to be positive for serum IgA class endomysial antibodies. These included eight strong positives, eight positives, and five weak positives. One-hundred-thirty-four children had small bowel biopsies performed. Endomysial antibodies were found in all children with severe villous atrophy on a gluten-containing diet who were diagnosed as having coeliac disease. Three children with positive and four with weak-positive results did not have coeliac disease. One had partial villous atrophy consistent with the diagnosis of cow-milk-sensitive enteropathy and the others had a normal small bowel mucosa. This study confirms a strong association between endomysial antibodies and coeliac disease; however, not all cases with positive antibodies had the disease. At the present time, small bowel biopsy remains essential for the diagnosis of coeliac disease.
Chan
K N
KN
Academic Department of Paediatric Gastroenterology, Queen Elizabeth Hospital for Children, London, United Kingdom.
Phillips
A D
AD
Mirakian
R
R
Walker-Smith
J A
JA
D000293:Adolescent; D000906:Antibodies / Q000097:blood*; D002446:Celiac Disease / Q000175:diagnosis* / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D005903:Gliadin / Q000276:immunology; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D007223:Infant; D009132:Muscles / Q000276:immunology*; D011237:Predictive Value of Tests; D012189:Retrospective Studies
D000906:Antibodies; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D005903:Gliadin