Anti-endomysium and anti-gliadin antibodies as serological markers for coeliac disease in childhood: a clinical study to develop a practical routine

Acta Paediatr. 1995 Mar;84(3):294-8. doi: 10.1111/j.1651-2227.1995.tb13631.x.

Abstract

Anti-gliadin and anti-endomysium antibodies were analyzed in 174 children with suspected or verified coeliac disease with the aim of developing a practical routine. The biopsy was performed without knowledge of the antibody levels. To screen for coeliac disease is children younger than 2 years, we suggest the use of IgA anti-gliadin antibodies, giving a sensitivity of 100% and a specificity of 86%. In older children both tests should be used in parallel, i.e. a biopsy should be performed if at least one of the tests is positive, giving a sensitivity of 98% and a specificity of 81%. To avoid unnecessary biopsy before mucosal relapse can be demonstrated during gluten challenge in a child without clinical symptoms, we suggest that the tests are used as serial testing, i.e. a biopsy should be performed if both tests are positive.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Autoantibodies / analysis*
  • Biomarkers*
  • Biopsy
  • Celiac Disease / diagnosis*
  • Celiac Disease / immunology
  • Celiac Disease / pathology
  • Child
  • Child, Preschool
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Gliadin / immunology*
  • Humans
  • Immunoglobulin A / analysis*
  • Infant
  • Intestinal Mucosa / pathology
  • Jejunum / pathology
  • Male
  • Myofibrils / immunology*
  • Sensitivity and Specificity

Substances

  • Autoantibodies
  • Biomarkers
  • Immunoglobulin A
  • Gliadin