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Update on serologic testing in celiac disease.

Daniel A Leffler1, Detlef Schuppan

  • 1Celiac Center, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, USA. dleffler@caregroup.harvard.edu

The American Journal of Gastroenterology
|December 7, 2010
PubMed
Summary
This summary is machine-generated.

Accurate serologic tests, mainly ELISA-based, screen for celiac disease (CD) with high prevalence. Reevaluation of these tests is needed, with IgA autoantibodies against tissue transglutaminase remaining the standard for diagnosis.

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Area of Science:

  • Gastroenterology and Immunology
  • Diagnostic Medicine

Background:

  • Celiac disease (CD) diagnosis relies heavily on serologic testing.
  • ELISA (enzyme-linked immunosorbent assay)-based assays have significantly improved noninvasive screening and detection of CD.
  • The prevalence of CD is approximately 1:100 in many populations.

Purpose of the Study:

  • To review current serologic tests for celiac disease.
  • To evaluate the predictive power of single and combined serologic assays.
  • To discuss the need for tests assessing CD activity for future therapies.

Main Methods:

  • Review of available serologic tests for CD.
  • Analysis of antibodies against gliadin, endomysium, tissue transglutaminase, and deamidated gliadin.
  • Evidence-based assessment of test utility in various clinical settings.

Main Results:

  • Standardized ELISA-based assays for IgA autoantibodies against tissue transglutaminase are the preferred diagnostic method.
  • Novel developments in serologic testing are emerging.
  • The predictive value of different tests requires ongoing evaluation.

Conclusions:

  • Tissue transglutaminase IgA autoantibody testing remains the gold standard for celiac disease diagnosis.
  • Further research is needed to develop tests for monitoring CD activity.
  • Accurate diagnostic tools are crucial for managing celiac disease and evaluating new treatments.