ANTI-ENDOMYSIUM AND ANTIGLIADIN ANTIBODIES AS SEROLOGICAL MARKERS FORCELIAC-DISEASE IN CHILDHOOD - A CLINICAL-STUDY TO DEVELOP A PRACTICALROUTINE

Anti-gliadin and anti-endomysium antibodies were analysed in 174 child ren with suspected or verified coeliac disease with the aim of develop ing a practical routine. The biopsy was performed without knowledge of the antibody levels. To screen for coeliac disease is children younge r than 2 years, we suggest the use of IgA anti-gliadin antibodies, giv ing a sensitivity of 100% and a specificity of 86%. In older children both tests should be used in parallel, i.e. a biopsy should be perform ed if at least one of the tests is positive, giving a sensitivity of 9 8% and a specificity of 81%. To avoid unnecessary biopsy before mucosa l relapse can be demonstrated during gluten challenge in a child witho ut clinical symptoms, we suggest that the tests are used as serial tes ting, i.e. a biopsy should be performed if both tests are positive.