Abstract
Serum IgA against gluten is a good marker of untreated coeliac disease, especially in children. In this study a new test (Pharmacia Gluten IgA EIA) was evaluated.
Assay was performed in microstrips which were gliadincoated. Total test time: <3 h. The cut-off was established from 84 healthy children. It was determined to 25 arbitrary units (AU).
Study population: In total 91 children who had undergone a jejunal biopsy were studied. Of them 47 had villous atrophy and 44 had normal mucosa, 10 children with villous atrophy, from the previous group, treated with gluten-free diet. 19 children undergoing gluten challenge and biopsed the third time.
Results: Untreated children: All 47 children with villous atrophy had significant amounts of anti-gliadin IgA giving a sensitivity of 100%. 37 children out of 44 with normal mucosa had antibody levels <25 AU giving a specificity of 84%. The test gave a correct diagnosis in 92% of the cases.
After gluten-free diet: All treated children reacted with disappearance of anti-gliadin IgA (<25 AU).
After gluten-challenge: All children had anti-gliadin IgA above 25 AU.
Conclusion: All children with villous atrophy had significant antibody levels, which means that the test is a good screening method for candidates for jejunal biopgy. It is also a useful test for patient adherence to gluten-free diet.
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Juto, P., Almlöf, U., Hernell, O. et al. EVALUATION OF ANTIGLIADIN IgA AS A SCREENING METHOD FOR COELIAC DISEASE IN CHILDREN. Pediatr Res 22, 234 (1987). https://doi.org/10.1203/00006450-198708000-00127
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DOI: https://doi.org/10.1203/00006450-198708000-00127