Serum Anti-gliadin Antibody Profile in Childhood Protracted Diarrhoea Due to Coeliac Disease and Other Causes in a Developing Country

Abstract

Serum anti-gliadin antibody (AGA) titres were estimated by diffusion in a gel enzyme-linked immunosorbent assay in children with coeliac disease (n = 11), protracted diarrhoea of non-coeliac causes (n = 110), acute gastroenteritis (n = 20), protein energy malnutrition (n = 20), and asymptomatic, well-nourished children (n = 66). The mean IgG and IgA AGA titres were significantly higher (p less than 0.001) in children with coeliac disease than in any other groups. There was no significant difference (p greater than 0.01) in AGA titres in relation to age, nutritional status, or severity of villous injury. In patients with coeliac disease AGA titres showed a good correlation with disease activity. The specificity and sensitivity of the assay are discussed.

Celiac Disease in India: Are They True Cases of Celiac Disease?

“…However, until the 1950s it was not known (6,7,17), where wheat is a staple food. In all of these series, diagnosis of CD was established on the basis of villous atrophy on intestinal mucosal biopsy.…”

“…However, there are sporadic reports of CD from Arabia (1)(2)(3) and India (4)(5)(6)(7). Celiac disease was reported from India in 1966 (4), and subsequently Nelson et al (8) reported a series of 17 immigrant Asian children with CD from Birmingham.…”

“…In 1989, Khoshoo et al (7) from India showed that the AGA test was useful in distinguishing CD from other causes of villous atrophy. However, in that study the number of CD cases was small (n ‫ס‬ 11), and a cutoff value of AGA, which could be used to screen children for further workup, was not given.…”

“…Celiac disease was reported from India in 1966 (4), and subsequently Nelson et al (8) reported a series of 17 immigrant Asian children with CD from Birmingham. However, there has been doubt recently regarding the existing literature on CD from Asia (5) because diagnoses were based on villous atrophy only (1)(2)(3)(4)6), and in developing countries many conditions other than CD can give rise to severe villous atrophy (7). In the modified ESPGHAN criteria (9), only biopsy changes and clinical response to gluten-free diet (GFD) are sufficient to make a diagnosis of CD, but in developing countries we should have some additional criteria to distinguish CD from other causes of villous atrophy.…”

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

“…Khoshoo et al (30), in India, reported that IgG and IgA antigliadin antibodies were significantly higher in children with celiac disease than in children with other enteropathies.…”