Because of the different sensitivity and specificity of serologic tests, the search for silent celiac disease is usually performed with the combined or sequential use of several tests.
Among these, the IgA-class endomysium antibody test has the highest specificity and positive predictive value, but it may overlook IgA-deficient patients.
To test a new one-step screening approach, serum samples from 427 apparently healthy. 3-to 6-year-old Hungarian children were investigated for IgA-class and IgG-class endomysium antibodies using monkey esophagus and human jejunum as substrates.
Five new cases with flat mucosa were identified by strong endomysium antibody positivity and subsequent jejunal biopsy, yielding a celiac disease prevalence of 1 : 85.
An additional child may have latent celiac disease (slight histologic changes at present).
Two of the screening-detected celiac patients exhibited only IgG-class endomysium antibodies due to associated IgA-deficiency.
Despite the young age of the screened population, antigliadin antibodies were positive in only three of the five celiac patients.
Prevalence of celiac disease in the study population was much higher than expected on the basis of antigliadin antibody-based studies.
The screening system used detected celiac cases in which there was IgA-deficiency and those in which there was not and also those negative for antigliadin antibodies. (...)
Mots-clés Pascal : Coeliaque maladie, Dépistage, Prévalence, Gliadine, Anticorps, Séropositivité, Spécificité type, IgA, IgG, Exploration clinique, Essai pilote, Age préscolaire, Enfant, Homme, Appareil digestif pathologie, Intestin pathologie, Malabsorption intestinale, Immunopathologie, Prévention
Mots-clés Pascal anglais : Coeliac disease, Medical screening, Prevalence, Gliadin, Antibody, Seropositivity, Type specificity, IgA, IgG, Clinical investigation, Pilot test, Preschool age, Child, Human, Digestive diseases, Intestinal disease, Intestinal malabsorption, Immunopathology, Prevention
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0074094
Code Inist : 002B13B03. Création : 31/05/1999.