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Scand J Prim Health Care. 2000 Jun;18(2):105-10.

Endomysium antibodies are superior to gliadin antibodies in screening for coeliac disease in patients presenting supposed functional gastrointestinal symptoms.

Author information

1
Department of Public Health and Caring Sciences, University Hospital, Uppsala, Sweden.

Abstract

OBJECTIVE:

To study the accuracy of IgA- and IgC-gluten antibodies and endomysium antibodies as screening tools for endoscopy with small bowel biopsy for histologic diagnosing of coeliac disease.

DESIGN:

Comparing serology with histologic examination--the "gold standard" for diagnosing coeliac disease.

SETTINGS:

1. The municipality of Osthammar, Sweden. 2. The catchment area of the University Hospital, Uppsala, Sweden.

PATIENTS:

1. A random subsample (50 with dyspepsia, 50 with irritable bowel syndrome and 50 symptomless) of a representative sample from an adult Swedish general population (20-80 years; n = 1260). 2. All patients with a diagnosis of coeliac disease admitted to the University Hospital in Uppsala, Sweden during the course of 10 months.

MAIN OUTCOME MEASURES:

The accuracy of IgA- and IgG-gluten antibodies and endomysium antibodies.

RESULTS:

There were no significant correlations between IgA-gluten antibodies and IgG-gluten antibodies, on the one hand, and symptoms or symptom severity, on the other. Using duodenal biopsy results as the gold standard, IgA-gluten antibodies had a low specificity and IgG-gluten antibodies a low sensitivity, whereas endomysium antibodies had an excellent accuracy.

CONCLUSION:

Endomysium antibodies seem to be the screening test of choice. The load of diagnostic upper endoscopies would be considerably decreased compared to using gluten antibodies.

PMID:
10944065
[Indexed for MEDLINE]
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