title: Serological testing for celiac disease in adults.
abstract: OBJECTIVE
  We present a systematic review on the performance of currently available methods for serological diagnosis of celiac disease (CD) and the role of human leukocyte antigen (HLA) typing.
  
  
  OBJECTIVE
  A literature survey was conducted using PubMed, MeSH database, Web of Science as well as manual searches.
  
  
  RESULTS
  Tissue transglutaminase antibodies (tTG) (IgA) (tested in nine studies) show sensitivities and specificities in the range of 0.76-0.968 and 0.909-0.98, and deamidated gliadin peptide (DGP) (IgA and IgG) (tested in eight studies) show sensitivities and specificities in the range of 0.69-0.984 and 0.903-1. Endomysial antibodies (EMA) (tested in five studies) show sensitivities and specificities in the range of 0.61-0.937 and 0.98-1, respectively. Combination assays (tested in three studies) using DGP + tTG and DGP (IgA + IgG) show sensitivities and specificities in the range of 0.87-1 and 0.8-1, respectively. HLA DQ2/DQ8 may be necessary for the development of CD-HLA DQ2 in particular. A possible close correlation may also exist between CD and HLA-G.
  
  
  CONCLUSIONS
  DGP and tTG for serological testing for CD show equivalent diagnostic performance. More studies with, in particular, DGP alone and in combination with tTG are necessary before a firm recommendation can be made. HLA typing to exclude CD may still be controversial. It still seems premature to diagnose celiac disease in adults based on serology alone.
authors.affiliation: Gentofte Hospital HR-Research Unit and Department of Gastroenterology F, Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Astrid Collatz
authors.initials: AC
authors.lastname: Schyum
authors.affiliation: Gentofte Hospital HR-Research Unit and Department of Gastroenterology F, Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Jüri Johannes
authors.initials: JJ
authors.lastname: Rumessen
keywords: Celiac disease; HLA DQ2/DQ8; diagnosis; gliadin; serological testing; transglutaminase