Use of a threshold serum level of anti-gliadin antibodies improves diagnostic efficiency of the test in adult coeliac disease but is unreliable as a screening test

Measurement of anti-gliadin antibodies is considered a highly sensitive test for coeliac disease in children. Specificity, however, appears to vary due to the presence of anti-gliadin antibodies in other diseases. Sensitivity and specificity of anti-gliadin antibody measurement for coeliac disease i...

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Bibliographic Details
Published inThe Italian journal of gastroenterology Vol. 28; no. 2; p. 70
Main Authors Picarelli, A, Triglione, P, Mariani, P, Di Giovambattista, F, Greco, M, Gurnari, M, Paoluzi, P, Bonamico, M, Ballati, G
Format Journal Article
LanguageEnglish
Published Italy 01.02.1996
Subjects
Adult
Biopsy
Case-Control Studies
Celiac Disease - diagnosis
Celiac Disease - epidemiology
Enzyme-Linked Immunosorbent Assay
Female
Gliadin - immunology
Humans
Immunoglobulin A - blood
Immunoglobulin G - blood
Jejunum - pathology
Male
Reference Values
ROC Curve
Sensitivity and Specificity
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Summary:Measurement of anti-gliadin antibodies is considered a highly sensitive test for coeliac disease in children. Specificity, however, appears to vary due to the presence of anti-gliadin antibodies in other diseases. Sensitivity and specificity of anti-gliadin antibody measurement for coeliac disease in adults has, thus, been assessed using the ratio of the densitometric unit test/the mean +3SD of densitometric unit values of a pool of sera of healthy biopsy-proven controls. Anti-gliadin antibodies-A and G were measured separately with an enzyme-linked immunosorbent assay in 64 coeliacs (20 males; 44 females; age range 14-71 years) with diagnosis confirmed at jejunal biopsy; and in 60 controls (25 males; 35 females; age range 16-69 years) with normal jejunal biopsy. Detection of anti-gliadin antibodies-A and G had a sensitivity of 58% and 61%, respectively, and a specificity of 85% and 94%. For the procedure a Receiver Operating Characteristic analysis was used. Considering anti-gliadin antibodies-A and G values of at least 0.9 densitometric unit, sensitivity was 50% and 60%, respectively, whereas specificity was 100% for both. These findings confirm the low sensitivity of these measurements in adult coeliacs and thus the unreliability for screening. The high specificity, when using a threshold value of 0.9 densitometric unit, may be useful in the evaluation of adults with suspected coeliac disease.
ISSN:0392-0623