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Intestinal Anti-Endomysium Antibodies Are a Useful Tool for Diagnosing Celiac Disease in Pediatric and Adult Patients
Chiara Zanchi1, Fabiana Ziberna1, Alessia Padoin2
1Institute for Maternal and Child Health, I.R.C.C.S. Burlo Garofolo, Via dell'Istria 65/1, 34100 Trieste, Italy.
Insights
Intestinal anti-endomysium antibodies are highly accurate for diagnosing celiac disease in both children and adults. This marker
Area of Science:
- Gastroenterology
- Immunology
- Pediatrics
Background:
- Intestinal anti-endomysium antibodies are a specific marker for celiac disease.
- Previous studies indicated high diagnostic accuracy in pediatric patients.
- The marker's diagnostic utility in adults remained unevaluated.
Purpose of the Study:
- To evaluate the diagnostic specificity and sensitivity of intestinal anti-endomysium antibodies in both pediatric and adult populations.
- To compare the marker's accuracy across different age groups.
Main Methods:
- Prospective multicentric study involving 291 patients (146 children, 145 adults) undergoing intestinal endoscopy.
- Assessment of serological celiac disease markers and HLA type.
- Analysis of intestinal biopsies for histology and anti-endomysium antibodies via biopsy culture assay.
Main Results:
- High diagnostic sensitivity and specificity of intestinal anti-endomysium antibodies were confirmed in children.
- The study additionally proved high diagnostic accuracy of this marker in adults.
- Celiac disease was diagnosed in 77 children and 34 adults.
Conclusions:
- Intestinal anti-endomysium antibodies demonstrate high diagnostic accuracy in both children and adults.
- This marker can be reliably used for celiac disease diagnosis across all age groups.
- Implementing this marker in diagnostic work-up aids clinicians in accurate celiac disease identification.
Abstract:
Intestinal anti-endomysium antibodies are a specific marker of celiac disease. The diagnostic accuracy of this marker seems high in pediatric patients and has not yet been investigated in adults, so the aim of this prospective multicentric study was to evaluate the specificity and sensitivity of this marker in childhood and adulthood. Pediatric and adult patients undergoing intestinal endoscopy for any intestinal condition were enrolled. Serological celiac disease markers and HLA type were evaluated in all patients. Intestinal biopsies were analyzed for standard histology and for intestinal anti-endomysium antibodies with biopsy culture assay. In this study, 291 patients (145 adults and 146 children) were included. In the adult population, 34 were diagnosed with celiac disease, 105 were controls, and, in 6, celiac disease was not confirmed. In the pediatric population, 77 were diagnosed with celiac disease, 57 were controls, and, in 12, celiac disease was not confirmed. High diagnostic sensitivity and specificity of intestinal anti-endomysium antibodies were confirmed in children and additionally proven in adults. To conclude, we can affirm that intestinal anti-endomysium antibodies can be detected with high diagnostic accuracy in both children and adults. The implementation of this marker in the diagnostic work-up would help clinicians to correctly identify celiac disease.
