[Importance of determining serologic markers in patients with celiac disease]

Coeliac disease is presently considered to be an autoimmune disorder. Basis for the diagnosis is the invasive histochemical examination of the intestinal biopsy. Pathologic changes are classified into three grades according to the villous atrophy. Due to the autoimmune process, the patients serum levels of the specific and nonspecific antibodies, more which easily accessible to investigation, are increase.

One hundred thirty six probands (32 with coeliakia, 72 with other gastrointestinal disorders and 32 healthy ones) were included into the study. The antiendomysial, antireticular and antigliadin antibodies were examined. Results were compared with the histological finding in the gut sample. The highest sensitivity was found for antigliadin IgA antibodies (81%) and antiendomysial antibodies (75%). High specificity of the reaction in healthy subjects as well as in those with other gastrointestinal disorders (up to 100%), was found for antiendomysial and antireticular antibodies.

The most appropriate screening test the diagnosis of coeliac disease, appears to be the examination of the antigliadin antibodies of the class IgA and that of antiendomysial antibodies. On the basis of serology, today's high rate of underdiagnosing the disease can be prevented. However, the tests cannot differentiate between different degrees of the histological damage of the gut.