Antibody pattern in childhood celiac disease

Background: We carried out a study of the antibody pattern in 50 celiac children [34 females (F) and 16 males (M); F/M, 2.1], ages 7 months-15 years, compared with that in 25 control subjects (13 females and 12 males) of the same age. Methods: IgA and IgG antigliadin antibodies (AGA) were determined with an enzyme-linked immunosorbent assay technique. IgA anti-R1-reticulin antibodies (ARA) and IgA antiendomysium antibodies (EmA) were determined with the fluorescein isothiocyanate-conjugate-labeled anti-human immunoglobulin technique. To compare sensitivity and specificity, EmA were identified using monkey esophagus and human umbilical cord as substrates. Results: While AGA (IgA and IgG) showed a high sensitivity but a low specificity, ARA showed a high specificity but a low sensitivity. Data on EmA showed a high sensitivity and specificity with both tissue sections, with monkey esophagus being mon sensitive (96%) and umbilical cord more specific (100%). Conclusions: Our results confirm the importance of celiac disease-related antibodies in identifying celiac children. Moreover, the easy availability of human umbilical cord indicates that it would be proper to use this tissue as substrate, instead of monkey esophagus, for EmA search in the future.