Original article—alimentary tractComparative Usefulness of Deamidated Gliadin Antibodies in the Diagnosis of Celiac Disease
Section snippets
Study Design
Serum samples were collected from patients referred to the Division of Gastroenterology and Hepatology at the Mayo Clinic (Rochester, MN) for the assessment of gastrointestinal symptoms, unexplained weight loss/anemia, or to rule out CD. All patients underwent small intestinal biopsy between January 1999 and December 2006. All serum samples were stored at or below −20°C. The study was approved by the Institutional Review Board of the Mayo Clinic (Rochester, MN).
Patients
Subjects whose serum samples were
Subject Characteristics
We evaluated serum antibodies from 92 biopsy-proven celiac patients and 124 biopsy-proven nonceliac controls. Patients and controls were similar regarding age and sex. Of 92 celiac patients, 50 had PVA, 4 had subtotal villous atrophy, and 38 had TVA. For simplicity, patients with mild or a partial degree of villous atrophy were categorized into a PVA group (54%), and patients with subtotal villous atrophy or TVA were categorized into a TVA group (46%). The demographic characteristics of
Discussion
The present study reports the diagnostic accuracy of a new deamidated gliadin antibody assay in a population of mainly adult patients who were selected only on the basis of histopathology. This represents a major difference from previous studies wherein a positive serologic test was the inclusion criterion for patient recruitment.16, 17 Our results showing the superiority of AGA II over AGA were consistent with previous studies;16, 17, 18 however, the sensitivity of AGA II antibodies in our
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2019, European Journal of Internal MedicineCitation Excerpt :Therefore, EMA should not be tested routinely in screening (alone or with TG2-Ab), but only used as a confirmatory test in case of uncertain diagnosis (i.e. weak positivity of TG2-Ab) in high-risk populations [4]. IgA/IgG-anti native gliadin antibodies (AGA) have a low sensibility and specificity, making them an obsolete test that should not be performed [73]. Deamidated gliadin peptide (DGP) IgG should be used in children younger than 2 years of age, because in this age group DGP are more sensitive than TG2-Ab [74].
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Supported by a National Institutes of Health grant (DK-057892) and the Mayo Foundation.