Clinical updates on diagnosing glutensensitive enteropathy
Keywords:
Coeliac disease, Antibodies, Intestinal biopsy, DiagnosisAbstract
In the last twenty years serology for the diagnosis of coeliac disease hasimproved substantially. As the result of our serological studies in 1998we proposed a gentle, low-risk, and cost eff ective algorithm for diagnosingvarious forms of gluten sensitive enteropathy, using a combinationof diff erent antibody determinations, namely IgA Endomysiumantibodies (EMA), Tissue-transglutaminase antibodies (IgA anti tTG,IgG anti tTG), IgA-and IgG antigliadin-antibodies. Performing routinelyserologic testing contributes to a decreased rate of endoscopicinterventions and improves the quality of the patient’s life.Downloads
References
Dickson B.C, Streutker CJ, Chetty R. Coeliac disease: an update for pathologists Review. Journal of clinical pathology. 2006;59:1008-16.
Celiac Disease Clinical Guideline JPGN. 2005;40:1-9.
NIH Consensus Statement on Celiac Disease. NIH Consens State Sci Statements. 2004 Jun 28-30; 21(1)1-22.
Kukainen K, Peraaho M, Collin P, Partanen J, Woollwy N, Kaartinen T, et al. Small bowel mucosal transglutaminase 2-specifi c IgA deposits in celiac disease without villous atrophy: a prospective and randomized study Scand J Gastroenerol.
;40:(5),546-72.
Goldstein NS, Underhill J. Morphologic features suggestive of gluten sensitive architecturally normal duodenal biopsy specimens. AJCP. 2001;116:63-71.
Collin P, Kaukinen K, Vogelsang H, Korponay-Szabo I, Sommer R, Schreier E, et al. Antiendomysial and antihuman recombinant tissue transglutaminase antibodies in the diagnosis if coeliac disease: a biopsy-proven European multicenter study Eur J Gastroenerol Hepatol. 2005;17(1):85-91.
Lembcke B, Schneider H, Lankisch PG. How safe is small bowel biopsy? Endoscopy. 1986;18(3):80-3.
Hadziselimovic F, Bürgin-Wolff A. Coeliac disease Lancet. 1998;351:9095:62-3.
Bürgin-Wolff A, Hadziselimovic F. Screening test for coeliac disease. Lancet. 1997;349:(9068):1843-4.
Bürgin-Wolff A, Dahlbom I, Hadziselimovic F, Petersson CJ. Antibodies ageinst human tissue transglutaminase and endomysium in diagnosing and monitoring coeliac disease Scand J Gastroenterol. 2002;37(6):685-91.
Bürgin-Wolff A, Gaze H, Hadziselimovic F, Huber H, Lentze M, Nussle D, et al. Antigliadin and antiendomysium antibody determination for coeliac disease Arch Dis Child. 1991;66(8):941-7.
Valdimarsson T, Franzen L, Grodzinsky E, Skoh T, Ström M. Is small bowel biopsy necessary in adults with suspected celiac disease and IgA antiendomysium antibodies? 100% positive predictive value for celiac disease in adults. Digestive Disease
and Sciences. 1996;14(1)83-7.
Mulder CJJ, Cellier C. Coeliac disease: changing views. Best Practice and Research Clinical Gastroenterology. 2005;19:(3)313-21.
Rostami K, Kerckheart J, Tiemessen R, von Blomberg BM, Meijr JW, Mulder CJ. Sensitivity of anti-endomysium and anti-gliadin antibodies in untreated celiac disease: disappointing in clinical practice. Am J Gastroenterol. 1999;94:(9):888-94.
Mulder C, Rostami K, Marsh MN. When is a coeliac a coeliac? Gut. 1998;42(4):594.