Study and Diagnose of Gluten Intolerance

The prevalence of the celiac disease is different, for example in Italy 1 in 250 people suffer from celiac disease, Ireland 1 to 300, in USA 1 in 133 Americans. Recent studies have shown that the disease may be more common in Africa, South America and Asia. Celiac disease affects people in different ways. Signs may be in the digestive system or in other parts of the body. Since this damage caused by our body's immune system, the disease is classified as an immune disease. However, it is considered a disease of worst absorbed because nutrients are not absorbed. The disease is also known as celiac disease or no tropical celiac disease, or enteropathy by sensitivity to gluten. Our aim has been to diagnose the gluten intolerance in the child by immunological methods. Both IgA and IgG anti-gliadin antibodies (AGA) are detected in sera of patients with gluten sensitive enteropathy (celiac disease). IgG anti-gliadin antibodies are more sensitive but are less specific markers for disease compared with IgA class antibodies. IgA anti-gliadin antibodies are less sensitive but are more specific. In clinical trials, the IgA antibodies have a specificity of 97% but the sensitivity is only 71%. That means that, if a patient is IgA positive, there is a 97% probability that they have celiac disease. Conversely, if the patient is IgA negative, there is only a 71% probability that the patient is truly negative for celiac disease. Therefore, a positive result is a strong indication that the patient has the disease but a negative result does not necessarily mean that they do not have it. False positive results are rather uncommon but false negative results can occur.

___

  • Carroccio A, Iacono G, Montalto G, (1993).Immunologic and absorptive tests in celiac disease: can they replace intestinal biopsies? Scand J. Gastroenterol; 28, 673-676.
  • Carroccio A , Vitale G, Di Prima L, (2002) Comparison of anti-transglutaminase ELISAs and anti-endomysial antibody assay in the diagnosis of celiac disease: a prospective study. Clin Chem., 48, 1546-1550. Green PH , Cellier C, (2007) Celiac disease . N Engl J Med; 357, 1731-43.
  • Mäki M , Mustalahti K , Kokkonen J. (2003). Prevalence of celiac disease among children in Finland. N. Engl. J. Med., 348, 2517-2524.
  • Picarelli A , Maiuri L , Frate A. (1996). Production of antiendomysial antibodies after in-vitro gliadin challenge of small intestine biopsy samples from patients with coeliac disease. Lancet; 348, 1065–1067.
  • Sapone A, Bai J, Ciacci C, (2012) Spectrum of gluten-related disorders: consensus on new nomenclature and classic cation. BMC Med., 10, 13.
  • Troncone R, Jabri B, (2011) Celiac disease and gluten-sensitivity. J Intern Med; 269: 582–90. Thompson WG, Longstreth GF, Drossman DA, (1999). Functional bowel disorders and functional abdominal pain; 45, 43-47.
  • Verdu EF, Armstrong D, Murray JA, (2009) Between celiac disease and irritable bowel syndrome: the no man’s land of gluten sensitivity. Am J Gastroenterol; 104, 1587-1594.
  • Walker-Smith JA, Guandalini S, Schmitz J, (1990) Revised criteria for diagnosis of coeliac disease. Arch Dis Child., 65, 909-911.