Comparative analysis of serologic screening tests for the initial diagnosis of celiac disease.
OBJECTIVE
To prospectively evaluate and compare the sensitivity, specificity, and positive and negative predictive values of serum antigliadin (AGA) and antiendomysium antibodies (EMA) in predicting the initial diagnosis of celiac disease.


METHODS
Sera were tested prospectively for IgA and IgG AGA by enzymed-linked immunosorbent assay and IgA EMA by immunofluorescence techniques on monkey esophagus and human umbilical cord sections in 95 pediatric patients referred for duodenal biopsies.


METHODS
Ninety-five pediatric patients were referred for duodenal biopsies, with a clinical suspicion of celiac disease; 24 of those patients had celiac disease by criteria of the European Society for Pediatric Gastroenterology and Nutrition.


METHODS
A pediatric gastroenterology clinic of a tertiary care pediatric university hospital.


RESULTS
EMA testing on human umbilical cords was the most specific but was also the least sensitive. All the patients with biopsy-proven celiac disease were identified by either one or both serologic tests (100% combined sensitivity). The combination of AGA and EMA on monkey esophagus resulted in a negative predictive value of 100% accuracy.


CONCLUSIONS
A combination of AGA and EMA tests resulted in 100% sensitivity and 100% negative predictive value, useful in selecting patients for duodenal biopsy.
Russo
P A
PA
Department of Pathology, Gastroenterology Service, Hôpital Ste-Justine, and Université de Montréal, Montréal, Québec, Canada.
Chartrand
L J
LJ
Seidman
E
E
D000293:Adolescent; D001323:Autoantibodies / Q000097:blood*; D016022:Case-Control Studies; D002446:Celiac Disease / Q000097:blood / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D004386:Duodenum / Q000473:pathology; D005260:Female; D005903:Gliadin / Q000276:immunology*; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D007223:Infant; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012698:Serologic Tests
D001323:Autoantibodies; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D005903:Gliadin