Serological aspects of coeliac disease

We have evaluated the sensitivity and specificity of serum anti-gliadin, anti-reticulin and anti-endomysium antibody determinations for the diagnosis of coeliac disease. Serum samples from 54 children and 9 adults with untreated coeliac disease were analysed for anti-gliadin antibodies and compared to the results obtained for 111 non coeliac controls (72 children, 39 adults) and 221 healthy blood donors. This yields sensitivities of 87% and 86% for IgA and IgG antibodies. Specificities were respectively of 95.5% and 91%. Anti-reticulin and anti-endomysium IgA were analysed in a more limited number of sera. Specificity of both tests was of 100% for the IgA class of antibody. However sensitivity was only of 64% for anti-reticulin IgA but was of 100% for anti-endomysium IgA. These results indicate that combination of anti-gliadin antibodies (IgA and IgG), anti-reticulin and anti-endomysium IgA may be recommended as screening tests to better select patients suspected of coeliac disease for jejunal biopsy.