OBJECTIVE: To study the accuracy of IgA- and IgC-gluten antibodies and endomysium antibodies as screening tools for endoscopy with small bowel biopsy for histologic diagnosing of coeliac disease. DESIGN: Comparing serology with histologic examination--the "gold standard" for diagnosing coeliac disease. SETTINGS: 1. The municipality of Osthammar, Sweden. 2. The catchment area of the University Hospital, Uppsala, Sweden. PATIENTS: 1. A random subsample (50 with dyspepsia, 50 with irritable bowel syndrome and 50 symptomless) of a representative sample from an adult Swedish general population (20-80 years; n = 1260). 2. All patients with a diagnosis of coeliac disease admitted to the University Hospital in Uppsala, Sweden during the course of 10 months. MAIN OUTCOME MEASURES: The accuracy of IgA- and IgG-gluten antibodies and endomysium antibodies. RESULTS: There were no significant correlations between IgA-gluten antibodies and IgG-gluten antibodies, on the one hand, and symptoms or symptom severity, on the other. Using duodenal biopsy results as the gold standard, IgA-gluten antibodies had a low specificity and IgG-gluten antibodies a low sensitivity, whereas endomysium antibodies had an excellent accuracy. CONCLUSION: Endomysium antibodies seem to be the screening test of choice. The load of diagnostic upper endoscopies would be considerably decreased compared to using gluten antibodies.
OBJECTIVE: To study the accuracy of IgA- and IgC-gluten antibodies and endomysium antibodies as screening tools for endoscopy with small bowel biopsy for histologic diagnosing of coeliac disease. DESIGN: Comparing serology with histologic examination--the "gold standard" for diagnosing coeliac disease. SETTINGS: 1. The municipality of Osthammar, Sweden. 2. The catchment area of the University Hospital, Uppsala, Sweden. PATIENTS: 1. A random subsample (50 with dyspepsia, 50 with irritable bowel syndrome and 50 symptomless) of a representative sample from an adult Swedish general population (20-80 years; n = 1260). 2. All patients with a diagnosis of coeliac disease admitted to the University Hospital in Uppsala, Sweden during the course of 10 months. MAIN OUTCOME MEASURES: The accuracy of IgA- and IgG-gluten antibodies and endomysium antibodies. RESULTS: There were no significant correlations between IgA-gluten antibodies and IgG-gluten antibodies, on the one hand, and symptoms or symptom severity, on the other. Using duodenal biopsy results as the gold standard, IgA-gluten antibodies had a low specificity and IgG-gluten antibodies a low sensitivity, whereas endomysium antibodies had an excellent accuracy. CONCLUSION: Endomysium antibodies seem to be the screening test of choice. The load of diagnostic upper endoscopies would be considerably decreased compared to using gluten antibodies.
Authors: Brooks D Cash; Joel H Rubenstein; Patrick E Young; Andrew Gentry; Borko Nojkov; Dong Lee; A Hirsohi Andrews; Richard Dobhan; William D Chey Journal: Gastroenterology Date: 2011-07-14 Impact factor: 22.682
Authors: Marjorie M Walker; Joseph A Murray; Jukka Ronkainen; Pertti Aro; Tom Storskrubb; Mauro D'Amato; Brian Lahr; Nicholas J Talley; Lars Agreus Journal: Gastroenterology Date: 2010-04-13 Impact factor: 22.682
Authors: Rok Seon Choung; Alberto Rubio-Tapia; Brian D Lahr; Robert A Kyle; Michael J Camilleri; G Richard Locke; Nicholas J Talley; Joseph A Murray Journal: Clin Gastroenterol Hepatol Date: 2015-05-16 Impact factor: 11.382