Digestive Diseases and Sciences

, Volume 41, Issue 1, pp 83–87

Is small bowel biopsy necessary in adults with suspected celiac disease and IgA anti-endomysium antibodies?

100% Positive predictive value for celiac disease in adults

Authors

  • Trausti Valdimarsson
    • Department of Internal Medicine, Immunology & Infectious Diseases, Faculty of Health SciencesUniversity Hospital of Linköping
    • Department of Pathology, Immunology & Infectious Diseases, Faculty of Health SciencesUniversity Hospital of Linköping
    • Department of Microbiology, Immunology & Infectious Diseases, Faculty of Health SciencesUniversity Hospital of Linköping
  • Lennart Franzen
    • Department of Internal Medicine, Immunology & Infectious Diseases, Faculty of Health SciencesUniversity Hospital of Linköping
    • Department of Pathology, Immunology & Infectious Diseases, Faculty of Health SciencesUniversity Hospital of Linköping
    • Department of Microbiology, Immunology & Infectious Diseases, Faculty of Health SciencesUniversity Hospital of Linköping
  • Ewa Grodzinsky
    • Department of Internal Medicine, Immunology & Infectious Diseases, Faculty of Health SciencesUniversity Hospital of Linköping
    • Department of Pathology, Immunology & Infectious Diseases, Faculty of Health SciencesUniversity Hospital of Linköping
    • Department of Microbiology, Immunology & Infectious Diseases, Faculty of Health SciencesUniversity Hospital of Linköping
  • Thomas Skogh
    • Department of Internal Medicine, Immunology & Infectious Diseases, Faculty of Health SciencesUniversity Hospital of Linköping
    • Department of Pathology, Immunology & Infectious Diseases, Faculty of Health SciencesUniversity Hospital of Linköping
    • Department of Microbiology, Immunology & Infectious Diseases, Faculty of Health SciencesUniversity Hospital of Linköping
  • Magnus Ström
    • Department of Internal Medicine, Immunology & Infectious Diseases, Faculty of Health SciencesUniversity Hospital of Linköping
    • Department of Pathology, Immunology & Infectious Diseases, Faculty of Health SciencesUniversity Hospital of Linköping
    • Department of Microbiology, Immunology & Infectious Diseases, Faculty of Health SciencesUniversity Hospital of Linköping
Intestinal Disorders, Inflammatory Bowel Disease, Immunology, and Microbiology

DOI: 10.1007/BF02208588

Cite this article as:
Valdimarsson, T., Franzen, L., Grodzinsky, E. et al. Digest Dis Sci (1996) 41: 83. doi:10.1007/BF02208588

Abstract

The comparative diagnostic value of IgA anti-endomysium and IgA antigliadin antibodies in adults with histologically confirmed celiac disease is reported. Sera from 144 adult patients (without concurrent dermatitis herpetiformis or IgA deficiency) who underwent small bowel biopsy were analyzed for both IgA anti-endomysium and IgA anti-gliadin antibodies. Nineteen patients (13%) had celiac disease. The presence of IgA antiendomysium antibodies had a sensitivity of 74% and a specificity of 100%. The positive and negative predictive values were 100% and 96%, respectively, and the diagnostic accuracy was 97%. In contrast, IgA anti-gliadin antibodies had positive and negative predictive values of 28% and 96%, respectively, with a diagnostic accuracy of 71%. Based on these data, we suggest that small bowel biopsy is not necessary to diagnose celiac disease in symptomatic adults with IgA antiendomysium antibodies. Due to a negative predictive value of 96%, some symptomatic adults lacking anti-endomysium antibodies will not be correctly diagnosed without small bowel biopsy.

Key Words

celiac diseaseIgA anti-endomysium antibodiesIgA anti-gliadin antibodiessmall bowel biopsy
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Copyright information

© Plenum Publishing Corporation 1996