Serological Markers and Celiac Disease

Abstract

SummaryWe analyze the diagnostic efficacy of two celiac disease serological markers: anti‐gliadin (IgA and IgG class) and anti‐endomysium IgA‐class (EmA‐IgA) antibodies applied to 336 serum samples from celiac patients on both gluten‐challenge and gluten‐free diets, and a control group. The anti‐gliadin and anti‐endomysium antibodies levels were significantly higher among the gluten‐consuming celiac patients than in the other groups. The greatest efficacy in diagnosing celiac disease was achieved in the Ema‐IgA class test. The IgA‐class anti‐gliadin antibodies proved to be more specific, with a higher positive test predictive value than the IgG‐class anti‐gliadin antibodies, whereas the latter proved to be more sensitive, with a higher negative test predictive value than those of the IgA‐class anti‐gliadin antibodies. Our results also demonstrate that the simultaneous assessment of anti‐gliadin IgA‐ and IgG‐class antibodies constitutes a valid test in selecting patients suspected of having celiac disease. In turn the EmA‐IgA antibodies constitute a confirmative test for indication of an intestinal biopsy.