Adult population screening for coeliac disease: comparison of tissue-transglutaminase antibody and anti-endomysial antibody tests.
Serological screening tests for coeliac disease have significantly advanced the diagnosis of this condition. The very high specificity (almost 100%) of anti-endomysial antibody detection has been repeatedly confirmed, whereas a lower specificity (90-95%) is found with anti-tissue transglutaminase antibody assays. In the study by Malekzadeh and colleagues, a group of study participants were identified with raised anti-tissue transglutaminase antibodies, but the endomysial antibody test was negative in 86%. Although many of these participants were found to have raised intra-epithelial lymphocytes in their small intestinal mucosa, there is currently insufficient evidence to confidently diagnose gluten-sensitive disease in these patients. Hence, their report that a minimum prevalence of 1:104 of gluten sensitivity is found in the general population of Iran is likely to be an over-estimate and requires confirmation.
Feighery
Conleth
C
Trinity College Centre for Health Sciences, St James Hospital, Dublin, Ireland. con.feighery@tcd.ie
Conlon
Niall
N
Jackson
John
J
D000328:Adult; D000906:Antibodies / Q000097:blood; D001323:Autoantibodies / Q000097:blood*; D002446:Celiac Disease / Q000175:diagnosis*; D004797:Enzyme-Linked Immunosorbent Assay; D019084:Fluorescent Antibody Technique, Indirect; D019204:GTP-Binding Proteins / Q000276:immunology*; D006801:Humans; D007070:Immunoglobulin A / Q000276:immunology; D008403:Mass Screening / Q000379:methods*; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D012680:Sensitivity and Specificity; D012698:Serologic Tests; D011503:Transglutaminases / Q000276:immunology*; D014908:Triticum / Q000276:immunology
D000906:Antibodies; D001323:Autoantibodies; D007070:Immunoglobulin A; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases; D019204:GTP-Binding Proteins