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Clinical inquiries: What blood tests help diagnose celiac disease?

Bonzo K Reddick1, Karen Crowell, Belinda Fu

  • 1Department of Family Medicine, University of North Carolina, Chapel Hill, NC, USA.

The Journal of Family Practice
|December 2, 2006
PubMed

Insights

Diagnosing celiac disease relies on small bowel biopsy. However, serum antibody tests like IgA tTG and IgA EMA can identify patients needing a biopsy, though IgA deficiency can cause false negatives.

Area of Science:

  • Gastroenterology and Immunology
  • Celiac Disease Diagnostics

Background:

  • Small bowel biopsy is the definitive method for diagnosing celiac disease.
  • Non-invasive serological tests are crucial for identifying individuals who may benefit from biopsy.

Purpose of the Study:

  • To evaluate the utility of serum antibody assays as initial screening tools for celiac disease.
  • To compare the diagnostic accuracy of various antibody tests, including IgA tTG, IgA EMA, IgA AGA, and IgG AGA.

Main Methods:

  • Review of existing literature, including systematic reviews and cross-sectional studies.
  • Analysis of the performance of four key serum antibody assays in identifying potential celiac disease patients.

Main Results:

  • Immunoglobulin A tissue transglutaminase (IgA tTG) and IgA endomysial antibody (IgA EMA) demonstrate the highest diagnostic accuracy among the tested assays.
  • Selective IgA deficiency can lead to false-negative results in IgA-based antibody assays.

Conclusions:

  • IgA tTG and IgA EMA are recommended as the most accurate first-line serological tests for celiac disease screening.
  • Clinicians should consider the possibility of selective IgA deficiency when interpreting negative IgA antibody results.

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