IGA CLASS ANTI-ENDOMYSIUM AND ANTI-RETICU LIN ANTIBODIES IN CELIAC ADULTS FOLLOWED AT PARIS

Objectives. - Circulating IgA class anti-endomysium and anti-reticulin antibodies are reliable serological markers for the diagnosis of coel iac disease. The aim of this study was to evaluate their diagnostic se nsitivity and specificity, and their prevalence in a group of coeliac adults taking a gluten-free diet followed in Ile-de-France. Methods. - One hundred and forty-five sera from 134 patients were examined for I gA and IgG anti-endomysium and anti-reticulin antibodies by indirect i mmunofluorescence. Sixty-eight patients were confirmed coeliacs; 8 pat ients with noncoeliac (unresponsive to a gluten-free diet) duodenal vi llous atrophy and 58 patients with no villous atrophy served as contro ls. Results. - In active coeliac disease, the sensitivity of anti-endo mysium and anti-reticulin antibodies was 88% and 50%, respectively. Th eir specificity was 100%: they were never detected in case of noncoeli ac villous atrophy. Under a strict gluten-free diet, their prevalence was 7% and 0%, respectively. Conclusion. - In the studied population, the diagnosis accuracy of IgA anti-endomysium antibodies confirms thei r usefulness in screening and follow-up of coeliac disease. The absenc e of anti-endomysium and anti-reticulin antibodies in those cases with noncoeliac villous atrophy suggests that in the latter, different imm unopathologic mechanisms, as compared with coeliac disease, are concer ned.