Compared with a previous study on the prevalence of clinically typical CD in the same region, the present investigation indicates a four-fold higher prevalence of asymptomatic CD. Coeliac-specific antibodies should, therefore, be measured much more widely in the presence of certain symptoms and risk factors. While in adults the measurement of EmA is sufficient to provide the indication for a small-intestine biopsy, both EmA and AGA should be determined before a biopsy is undertaken in children.
In both studied populations of adults and children, AGA disappeared in more than 50% of the cases. The appearance of AGA has to be interpreted as a non-specific immunomodulation phenomenon, confirming the low specificity of AGA as a serologic marker for celiac disease.
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