Abstract
The sera of 340 children undergoing small bowel biopsy because of suspected coeliac disease were tested for IgA- and IgG-class ARA and AGA. ARA were determined using an immunofluorescence method and AGA were measured by a solid-phase enzyme-linked immunosorbent assay. Altogether 44 children had flat mucosa (SVA), 43 partial villous atrophy (PVA) and 253 normal small bowel mucosa. The sensitivity of IgA-ARA to detect SVA was 93 %, specificity 100 % and positive predictive value 100 %. The corresponding figures for IgA-AGA were 86 %, 78 % and 41 %. IgA-ARA gave no wrong positive tests in contrast to that of IgA-AGA (59 %). The sensitivity increased (98 %) when the tests were combined meaning that the individual tests missed different patients. IgA-ARA was not suitable for screening SVA (sensitivity 41 %, positive predictive value 78 %) whereas IgG-AGA was a sensitive test (86 %) but its positive predictive value was only 25 %. In PVA the sensitivity of combined AGA tests was 88 % in contrast to that of ARA (1 %). We conclude that AGA tell when small bowel mucosal abnormality caused by gluten or other factors should be suspected and IgA-ARA emphasizes the need of small bowel biopsy to detect children with small, flat intestinal mucosa and coeliac disease.
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Mäki, M., Ståhlberg, MR., Hällström, O. et al. 46. PREDICTABILITY OF SMALL BOWEL MUCOSAL DAMAGE BY RETICULIN (ARA) AND GLIADIN ANTIBODIES (AGA). Pediatr Res 22, 103 (1987). https://doi.org/10.1203/00006450-198707000-00067
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DOI: https://doi.org/10.1203/00006450-198707000-00067