IGA ANTIENDOMYSIUM ANTIBODIES HAVE A HIGH POSITIVE PREDICTIVE VALUE FOR CELIAC-DISEASE IN ASYMPTOMATIC PATIENTS

被引:61
作者
GRODZINSKY, E [1 ]
HED, J [1 ]
SKOGH, T [1 ]
机构
[1] LINKOPING UNIV HOSP,DEPT MEDICOSURG RHEUMATOL,S-58185 LINKOPING,SWEDEN
关键词
ASYMPTOMATIC PATIENTS; CELIAC DISEASE; IGA ANTIENDOMYSIUM ANTIBODIES;
D O I
10.1111/j.1398-9995.1994.tb00124.x
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
Many attempts have been made to find screening tests for celiac disease to reduce the need for biopsy, or to achieve better selection criteria before intestinal biopsy. We have recently analyzed apparently healthy blood donors for antigliadin antibodies (AGA) to select subjects for further gastrointestinal investigation. A prevalence of gluten enteropathy of at least 1/256 was found in this population. The positive predictive value(+ PV), however, was only 20%. In the present study we have analyzed IgA antiendomysium antibodies (IgA-EmA) to estimate the sensitivity and specificity of the test, and determine whether or not the + PV of the assay increases when screening for adult celiac disease in an asymptomatic population. We found that asymptomatic persons with celiac disease may have IgA-EmA. We found a 100% specificity of IgA-EmA in the tested population of blood donors, whereas the sensitivity was about the same as that of IgA-AGA. This result of a + PV of 100% indicates that a positive IgA-EmA could replace biopsy in diagnosing celiac disease. However, further extended studies are needed to determine whether this is applicable in other populations. To screen patients for celiac disease, we recommend the easy and cheap IgA-AGA assay as a preliminary test and the IgA-EmA to verify the diagnosis and avoid unnecessary biopsies.
引用
收藏
页码:593 / 597
页数:5
相关论文
共 31 条
[1]   INCREASING INCIDENCE OF CELIAC-DISEASE IN SWEDEN [J].
ASCHER, H ;
KRANTZ, I ;
KRISTIANSSON, B .
ARCHIVES OF DISEASE IN CHILDHOOD, 1991, 66 (05) :608-611
[2]  
AXMACHER B, 1990, AM J IND MED, V17, P94
[3]   IGG, IGA AND IGE GLIADIN ANTIBODY DETERMINATIONS AS SCREENING-TEST FOR UNTREATED CELIAC-DISEASE IN CHILDREN, A MULTICENTER STUDY [J].
BURGINWOLFF, A ;
BERGER, R ;
GAZE, H ;
HUBER, H ;
LENTZE, MJ ;
NUSSLE, D .
EUROPEAN JOURNAL OF PEDIATRICS, 1989, 148 (06) :496-502
[4]  
CACCIARI E, 1985, LANCET, V1, P1469
[5]   IGA CLASS ENDOMYSIUM ANTIBODIES IN DERMATITIS-HERPETIFORMIS AND CELIAC-DISEASE [J].
CHORZELSKI, TP ;
SULEJ, J ;
TCHORZEWSKA, H ;
JABLONSKA, S ;
BEUTNER, EH ;
KUMAR, V .
ANNALS OF THE NEW YORK ACADEMY OF SCIENCES, 1983, 420 (DEC) :325-334
[6]   HIGH-FREQUENCY OF CELIAC-DISEASE IN ADULT PATIENTS WITH TYPE-I DIABETES [J].
COLLIN, P ;
SALMI, J ;
HALLSTROM, O ;
OKSA, H ;
OKSALA, H ;
MAKI, M ;
REUNALA, T .
SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY, 1989, 24 (01) :81-84
[7]   ATYPICAL CELIAC-DISEASE FOUND WITH SEROLOGIC SCREENING [J].
COLLIN, P ;
HALLSTROM, O ;
MAKI, M ;
VIANDER, M ;
KEYRILAINEN, O .
SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY, 1990, 25 (03) :245-250
[8]  
DIPIETRALATA MM, 1992, ITAL J GASTROENTEROL, V24, P352
[9]   ENDOMYSIAL ANTIBODY - IS IT THE BEST SCREENING-TEST FOR CELIAC-DISEASE [J].
FERREIRA, M ;
DAVIES, SL ;
BUTLER, M ;
SCOTT, D ;
CLARK, M ;
KUMAR, P .
GUT, 1992, 33 (12) :1633-1637
[10]  
FRY L, 1974, CLIN GASTROENTEROL, V3, P145