Screening for coeliac disease in apparently healthy blood donors.
As gliadin is a common food antigen for many people, we have developed an ELISA for the detection of class-specific antigliadin antibodies (AGA), with which sera from a large population of apparently healthy blood donors was analysed. A very high prevalence (1/256) of positive AGA was found. However, the positive predictive value (+PV) was found to be very low, 20% for IgA-AGA and 0% for IgG-AGA alone. When screening large populations with no or few symptoms, it is desirable to have a high +PV to avoid unnecessary biopsies. IgA antiendomysium antibodies (IgA-EMA) were evaluated both as a single test and in combination with IgA-AGA. When screening individuals for CD in a population with no or few symptoms the easy and cheap IgA-AGA assay should be used as a first test and the IgA-EMA to verify the diagnosis and avoid unnecessary biopsies.
Grodzinsky
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Department of Transfusion Medicine and Clinical Immunology, Linköping University Hospital, Sweden.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015551:Autoimmunity; D015415:Biomarkers / Q000097:blood; D001782:Blood Donors; D002446:Celiac Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005903:Gliadin / Q000276:immunology*; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood / Q000276:immunology*; D007074:Immunoglobulin G / Q000097:blood / Q000276:immunology; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D012698:Serologic Tests / Q000379:methods; D013548:Sweden / Q000453:epidemiology
D015415:Biomarkers; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D005903:Gliadin