A reliable screening test for childhood celiac disease: Fluorescent immunosorbent test for gliadin antibodies

Bürgin-Wolff, A; Bertele, R M; Berger, R.; Gaze, H; Harms, H. K.; Just, M; Khanna, Seema; Schürmann, K.; Signer, E; Tomovic, D.

doi:10.1016/s0022-3476(83)80229-7

Cited by 70 publications

(37 citation statements)

References 15 publications

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“…FIST was used for the determination of antibodies to gliadin and cow's milk proteins as described elsewhere [5,6,8,26]. [2] had to be applied in order to account for the fact that execution of biopsy partially depended on the result of the AB test.…”

Section: Methodsmentioning

confidence: 99%

“…IgE AB determinations have rarely been performed and have given contradictory results [1,3,13,22,28]. We attained 100% sensitivity and 84% specificity with IgG gliadin AB determinations in an earlier study investigating the diagnostic value of a fluorescent immunosorbent test (FIST) for untreated childhood CD (190 biopsied children: 72 CD, 118 disease controls) [8]. We later tried to improve the diagnostic value, i.e.…”

Section: Offprint Requests To: a Bttrgin-wolffmentioning

confidence: 99%

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IgG, IgA and IgE gliadin antibody determinations as screening test for untreated coeliac disease in children, a multicentre study

et al. 1989

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The diagnostic value of gliadin IgG, IgA and IgE antibody (AB) determinations using the fluorescent immunosorbent test was examined in 586 children with malabsorptive disorders and/or failure to thrive. All patients underwent jejunal biopsy and were on a gluten-containing diet. IgG AB were found in all patients (331/331) with untreated coeliac disease (CD) in our study, but IgA AB in only 295/331 (89%). Therefore a screening test based only on IgA AB determinations is not recommended. By contrast, 203 (80%) of 255 children with other malabsorptive disorders had no gliadin AB, 43 (16.5%) had only IgG AB and only 9 (3.5%) had IgG and IgA AB. IgE AB proved to be of no additional value as a diagnostic tool because they were found in a quarter of the children without CD. Statistical evaluation of combined IgG and IgA AB determination showed at least 96% sensitivity and a specificity of 97%. The subjective ("Bayesian") probability that an actual patient with a given AB test result has CD, is considered: a patient very probably has CD in the case of positive IgG and IgA AB, and no CD in the case of a negative AB result. In the case of negative IgA AB but positive IgG AB the physician's judgement ("prior probability") influences the ("posterior") probability of CD for an actual patient. In contrast to IgG AB, IgA AB decline rapidly after the introduction of a gluten-free diet and may be used for diet control after diagnosis.(ABSTRACT TRUNCATED AT 250 WORDS)

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Section: Methodsmentioning

confidence: 99%

Section: Offprint Requests To: a Bttrgin-wolffmentioning

confidence: 99%

IgG, IgA and IgE gliadin antibody determinations as screening test for untreated coeliac disease in children, a multicentre study

et al. 1989

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“…Patients with coeliac disease (CD) usually have substantial levels of serum antibodies to gluten [2,7,10,11,15]; this activity is mainly expressed by the IgG isotype [1,4,14]. Fairly high levels of such antibodies may be present also in patients with other intestinal disorders and in normal subjects [4,6].…”

Section: Introductionmentioning

confidence: 99%

Changes of Serum Antibody Activities to Various Dietary Antigens Related to Gluten Withdrawal or Challenge in Children with Coeliac Disease

Scott¹,

J²,

Brandtzæg³

1985

Int Arch Allergy Immunol

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IgG, IgA, and IgM serum antibody activities to gluten, a gluten fraction called glyc-gli, and antigens from egg and cow’s milk were monitored by an enzyme-linked immunosorbent assay (ELISA) in children with coeliac disease during treatment and gluten challenge. The IgA activity to gluten antigens showed in most patients a rapid and significant reduction after gluten withdrawal, whereas the IgG activity decreased more slowly. During gluten challenge, both these activities rose significantly, and the increases could usually be detected several months before overt clinical relapse. Such determinations, therefore, represent a valuable adjunct in the follow-up of children with coeliac disease. IgA activities to egg and cow’s milk antigens likewise tended to decrease after gluten withdrawal and increase during challenge, but the changes were less consistent for individual antigens. Nevertheless, monitoring of IgA activities to a selection of dietary antigens other than gluten may be particularly valuable when it comes to evaluation of intestinal responses in patients on a glutenfree diet.

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“…Many studies have used groups of adults as control, some of them without a jejunal biopsy (4,(32)(33)(34)(35)(36). In general, antigliadin IgA has proven to be more specific for celiac disease.…”

Section: Discussionmentioning

confidence: 99%

Serum antigliadin antibody levels as a screening criterion before jejunal biopsy indication for celiac disease in a developing country

Bahia

Rabello²,

Filho

et al. 2001

Braz J Med Biol Res

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The objective of the present study was to determine the efficacy of detection of antigliadin immunoglobulins G and A (IgG and IgA) for the diagnosis of celiac disease in a developing country, since other enteropathies might alter the levels of these antibodies. Three groups were studied: 22 patients with celiac disease (mean age: 30.6 months), 61 patients with other enteropathies (mean age: 43.3 months), and 46 patients without enteropathies (mean age: 96.9 months). Antigliadin IgG and IgA ELISA showed sensitivity of 90.9 and 95.5%, respectively. With the hypothetical values of prevalence ranging from 1:500 to 1:2000 liveborns, the positive predictive value varied from 8.5 to 2.3% for IgG and from 4.8 to 1.1% for IgA. Considering the patients without enteropathies, specificity was 97.8 and 95.7% for IgG and IgA, respectively. In patients with other enteropathies, specificity was 82.0 and 84.1%, respectively. When patients with and without other enteropathies were considered as a whole, specificity was 88.8 and 91.6%, respectively. The specificity of positive IgG or IgA was 93.5% in children without enteropathies and 78.7% in the presence of other enteropathies. The negative predictive value for hypothetical prevalences varying from 1:500 to 1:2000 liveborns was 99.9%. Thus, even in developing countries where the prevalence of non-celiac enteropathies is high, the determination of serum antigliadin antibody levels is a useful screening test prior to the jejunal biopsy in the investigation of intestinal malabsorption.

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A reliable screening test for childhood celiac disease: Fluorescent immunosorbent test for gliadin antibodies

Cited by 70 publications

References 15 publications

IgG, IgA and IgE gliadin antibody determinations as screening test for untreated coeliac disease in children, a multicentre study

IgG, IgA and IgE gliadin antibody determinations as screening test for untreated coeliac disease in children, a multicentre study

Changes of Serum Antibody Activities to Various Dietary Antigens Related to Gluten Withdrawal or Challenge in Children with Coeliac Disease

Serum antigliadin antibody levels as a screening criterion before jejunal biopsy indication for celiac disease in a developing country

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