Related Experiment Video
Updated: Sep 30, 2026
Recognition of Epidermal Transglutaminase by IgA and Tissue Transglutaminase 2 Antibodies in a Rare Case of Rhesus Dermatitis
Published on: December 15, 2011
Effectiveness of antigliadin antibodies as a screening test for celiac disease in children
L J Chartrand1, J Agulnik, T Vanounou
1Division of Pediatric Gastroenterology, Hôpital Sainte-Justine, Montreal, Que.
Insights
Serologic antigliadin antibody (AGA) testing effectively screens children for celiac disease, improving selection for duodenal biopsy. While valuable, AGA testing does not replace the gold standard intestinal biopsy for diagnosis.
Area of Science:
- Pediatric Gastroenterology
- Immunology
- Diagnostic Testing
Background:
- Celiac disease diagnosis in children often requires invasive procedures.
- Serologic markers can aid in identifying individuals at risk.
Purpose of the Study:
- To evaluate the predictive accuracy of antigliadin antibody (AGA) testing for celiac disease in pediatric patients.
- To assess the utility of AGA screening in selecting children for duodenal biopsy.
Main Methods:
- Prospective clinical assessment of 176 children referred for duodenal biopsy.
- Measurement of IgA and IgG AGA titres using ELISA.
- Correlation of AGA titres with duodenal biopsy results and clinical outcomes on a gluten-free diet.
Main Results:
- 30 out of 176 children were diagnosed with celiac disease.
- IgA AGA sensitivity was 80% and specificity 92%; IgG AGA sensitivity was 83% and specificity 79%.
- Combined IgA and IgG AGA testing showed 93% sensitivity and 71% specificity, with high negative predictive value (98%).
Conclusions:
- AGA screening improves patient selection for duodenal biopsy.
- AGA testing enhances the specificity of histologic diagnosis but cannot replace intestinal biopsy.
- AGA titres significantly decrease on a gluten-free diet, supporting its diagnostic utility.
Objective:
To test the effectiveness of serologic antigliadin antibody (AGA) testing in predicting celiac disease in children.
Design:
Prospective clinical assessment.
Setting:
Hôpital Sainte-Justine, montreal.
Patients:
A total of 176 children with possible celiac disease who were referred for duodenal biopsy between January 1992 and June 1995.
Outcome Measures:
IgA and IgG AGA titres, as determined by enzyme-linked immunosorbent assay (ELISA); duodenal biopsy; clinical outcome on a gluten-free diet.
Results:
Of the 176 children 30 were found to have celiac disease according to the criteria of the European Society of Pediatric Gastroenterology and Nutrition (ESPGAN). The sensitivity and specificity of the IgA AGA titre, as well as its positive and negative predictive values, were 80%, 92%, 67% and 96% respectively; the corresponding values for the IgG AGA titre were 83%, 79%, 45% and 96%. The respective values for IgA and IgG AGA titres combined were 93%, 71%, 43% and 98%. Only 2 of the 30 patients with celiac disease had false-negative results for both IgA and IgG AGA titres. The IgA and IgG AGA titres decreased significantly (p < 0.005) in all 11 patients after being on a gluten-free diet for at least 10 months and reached normal values in 8.
Conclusion:
AGA screening for celiac disease permits better selection of patients for duodenal biopsy and adds specificity to the histologic diagnosis. Such screening cannot replace intestinal biopsy, which remains the gold standard for diagnosis.
