[Evaluation of sensitivity and specificity of antigliadin antibodies for the diagnosis of celiac disease in childhood].
A retrospective study with the aim of evaluating sensitivity and specificity of antigliadin antibodies (AGA) was carried out. AGA values, IgA and IgG, and mucosal damage at intestinal biopsy were compared in each subject, on a sample of 245 subjects, who had undergone intestinal biopsy because of suspected coeliac disease (CD), from January 1991 to December 1993. 130 subjects (53.1%) were found to be suffering from CD, whereas the remaining 115 subjects (46.9%), who did not show any signs of the disease, were considered as controls. When we compared AGA values with mucosal damage we observed that IgA were normal in 24 (18.5%) and pathological in 106 (81.5%) coeliac patients, whereas they were normal in 107 (93%) and pathological in 8 (7%) controls. IgG values were normal in 17 (13.1%) and pathological in 113 (86.9%) coeliac patients, but normal in 75 (65.2%) and pathological in 40 (34.8%) controls. Data about AGA sensitivity related to age, showed IgA sensitivity varying from 80.4% in children under 1 year old to 70% in children over 10 years old and IgG sensitivity from 94.1% to 50%. Data about specificity related to age, showed IgA sensitivity varying from 78.7% in children under 1 year old to 100% in children over 10 years old and IgG specificity from 30.4% to 90.9%. Our results indicated that AGA-IgA had a total sensitivity or 81.5%, a total specificity of 93% and a concordance with intestinal damage of 86.9% while AGA-IgG had a total sensitivity of 86.9%, a total specificity of 65.2% and a concordance with intestinal damage of 76.7%. These data presented a modification on the basis of age, being higher in children under 3 years of age and decreasing with the increase in age. We conclude that AGA have great importance in suspect CD, but it is most important that their results are evaluated on the basis of age.
I Clinica Pediatrica, Università degli Studi, Catania.
G
G
Bottaro
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N
Rotolo
M
M
Spina
C
C
Sciuto
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S
Castiglione
G
G
Sanfilippo
S
S
Musumeci
D000906:Antibodies / Q000276:immunology*; D002446:Celiac Disease / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D005903:Gliadin / Q000276:immunology*; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis; D007074:Immunoglobulin G / Q000032:analysis; D007223:Infant; D007413:Intestinal Mucosa / Q000737:chemistry; D012189:Retrospective Studies
D000906:Antibodies; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D005903:Gliadin