title: Serologic markers of untreated celiac disease in Libyan children: antigliadin, antitransglutaminase, antiendomysial, and anticalreticulin antibodies.
abstract: BACKGROUND
  There are, as yet, no data available about the incidence of celiac disease in Libya. The aim of this study was to test the occurrence of serologic markers in a group of Libyan children with positive clinical and histologic findings indicative of celiac disease diagnosis.
  
  
  METHODS
  Thirty-nine children with untreated celiac disease and 50 healthy school children, all younger than 14 years, were included in the study. Enzyme-linked immunosorbent assay for immunoglobulin G and immunoglobulin A (IgA) antigliadin, antitissue transglutaminase, and anticalreticulin antibodies was used to evaluate the serologic markers of the celiac patients. Immunoglobulin A antiendomysial antibodies were detected by indirect immunofluorescence using human umbilical cord tissue.
  
  
  RESULTS
  Clinical symptoms at presentation were weight loss (82%), abdominal distension (61.5%), diarrhea or steatorrhea (59%), pallor (41%), abdominal pain (20.5%), constipation (15%), vomiting (10%), and short stature (7.7%). Most of these symptoms disappeared after introduction of a gluten-free diet. Of 39 patients, only 23 (59%) were endomysium positive and positive also in all other serologic markers. The second group of patients with positive clinical and biopsy findings but antiendomysial antibody-negative findings was subdivided into two subgroups according to the IgA antigliadin antibody results. Individuals in the IgA gliadin-negative subgroup also lacked IgA autoantibodies.
  
  
  CONCLUSIONS
  The authors' findings stress the importance of serologic testing not only for screening but also for confirmation of celiac disease.
authors.affiliation: Department of Immunology and Gnotobiology, Institute of Microbiology, Czech Academy of Sciences, Prague, Czech Republic. aashabani@hotmail.com
authors.forename: A
authors.initials: A
authors.lastname: Ashabani
authors.forename: H
authors.initials: H
authors.lastname: Errabtea
authors.forename: A
authors.initials: A
authors.lastname: Shapan
authors.forename: L
authors.initials: L
authors.lastname: Tuckova
authors.forename: H
authors.initials: H
authors.lastname: Tlaskalova-Hogenova
mesh_terms: D000293:Adolescent; D001323:Autoantibodies / Q000097:blood* / Q000276:immunology; D015415:Biomarkers / Q000097:blood; D002135:Calcium-Binding Proteins / Q000276:immunology*; D037282:Calreticulin; D002446:Celiac Disease / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology; D002648:Child; D004032:Diet; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D005903:Gliadin / Q000276:immunology*; D005983:Glutens / Q000008:administration & dosage; D006801:Humans; D007070:Immunoglobulin A / Q000276:immunology; D007074:Immunoglobulin G / Q000276:immunology; D015994:Incidence; D007583:Jejunum / Q000473:pathology; D008002:Libya / Q000453:epidemiology; D008297:Male; D012261:Ribonucleoproteins / Q000276:immunology*; D011503:Transglutaminases / Q000276:immunology*
chemical_list: D001323:Autoantibodies; D015415:Biomarkers; D002135:Calcium-Binding Proteins; D037282:Calreticulin; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D012261:Ribonucleoproteins; D005983:Glutens; D005903:Gliadin; D011503:Transglutaminases