High Prevalence of Silent Celiac Disease in Preschool Children Screened with IgA/IgG Antiendomysium Antibodies

Korponay-Szabó, Ilma Rita; Kovács, Judit B.; Czinner, A; Gorácz, G; Vámos, Adrienn; Szabó, T

doi:10.1097/00005176-199901000-00008

Cited by 107 publications

(91 citation statements)

References 15 publications

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“…Before the development of powerful screening methods for coeliac disease, the prevalence of coeliac disease in Caucasian populations was generally estimated to be in the order of 0.1 % [6]. During the last few years, the invention of sensitive methods, especially of the assay for endomysium antibodies, has led to a number of reports giving considerably higher prevalence figures, ranging from 0.3 % up to 1.2 %, among both children and adults [7,8]. Using the same endomysium antibody method, we previously found a prevalence of coeliac disease of 0.8 % among 1070 Finnish adults [9].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of coeliac disease in siblings of patients with Type I diabetes is related to the prevalence of DQB1 * 02 allele

et al. 2001

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Increased prevalence of coeliac disease in patients with Type I diabetes has been widely reported in Caucasian populations, with figures for prevalence varying from 1.0 to 7.8 % [1]. Certain HLA genotypes (especially, those positive for DR3-DQ2 haplotype) are more frequent in both of these diseases. First-degree relatives of patients with Type I diabetes have an increased risk for developing diabetes, a risk that is proportional to the degree of shared HLA risk alleles. It

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Section: Discussionmentioning

confidence: 99%

Prevalence of coeliac disease in siblings of patients with Type I diabetes is related to the prevalence of DQB1 * 02 allele

et al. 2001

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“…Therefore, EMA IgA are today accepted as a reliable and noninvasive screening test for CD. Moreover, a recent study reported the presence of EMA of IgG isotype only in celiac children with selective IgA deficiency (7). These authors reported a low prevalence of AGA in these celiac children, suggesting the need to use different serological tests to reveal CD in the presence of IgA deficiency.…”

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confidence: 99%

Celiac Disease Diagnosis in Misdiagnosed Children

et al. 2000

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Antiendomysial antibodies (EMA) are today considered the most sensitive and specific serological marker of celiac disease (CD). The aim of the present study was to assess the occurrence of EMA of IgG isotype in EMA IgA negative children with clinical suspicion of malabsorption and their relationship with CD. Serum EMA IgG1 determination was performed on 30 EMA IgA negative children with clinical suspicion of CD. Total serum IgA levels were further investigated. Sixty children with gastroenterological diseases other than CD were used as control disease patients and 63 healthy children were evaluated as the control group. Eighteen out of 30 children in the study showed EMA IgG1 positivity in sera and a villous height/crypt depth ratio Ͻ3:1 as index of intestinal atrophy. It is noticeable that a selective IgA deficiency was present in only 9 of 18 EMA IgG1 positive children. In addition, clinical symptoms, EMA IgG1, and mucosal atrophy disappeared after 8 -10 mo on a gluten-free diet. Neither EMA IgA nor EMA IgG1 were detected in the children in the control groups. The other 12 children in study group showed no histologic abnormalities and were EMA IgG1 negative. In this study, we reveal a group of EMA IgG1 CD children without IgA deficiency. The diagnosis was based on the presence of gluten-dependent typical serological and histologic features of CD. Our data suggest that EMA IgG1 determination could be a new tool in the diagnostic workup of CD, useful in avoiding possible misdiagnosis. Abbreviations CD, celiac disease EGDS, esophagogastroduodenoscopy EMA, antiendomysial antibodies AGA, antigliadin antibodies IgG1, immunoglobulins, G1 subclass GFD, gluten-free diet CD is a lifelong gluten intolerance characterized by villous flattening with crypt hyperplasia of the small bowel mucosa and improvement or normalization of the mucosal architecture after a GFD (1). The presence of circulating EMA, highly sensitive and specific for CD (2-5), and their disappearance after a GFD confirms the diagnosis (6). Therefore, EMA IgA are today accepted as a reliable and noninvasive screening test for CD. Moreover, a recent study reported the presence of EMA of IgG isotype only in celiac children with selective IgA deficiency (7). These authors reported a low prevalence of AGA in these celiac children, suggesting the need to use different serological tests to reveal CD in the presence of IgA deficiency.The aim of our study was to evaluate the occurrence of EMA IgG and their relationship to CD in a group of EMA IgA negative children with total or subtotal intestinal atrophy. MATERIALS AND METHODSSubjects. Thirty EMA IgA negative children (12 males and 18 females, mean age 10.6, range 2-16 y) with clinical suspicion of CD were enrolled in the study as the patient group.Sixty children (27 males and 33 females, mean age 11.3, range 4 -16 y) with gastroenterological diseases other than CD (17 lactose intolerance, 3 cow's milk intolerance, 15 esophagitis, and 25 infectious diarrhea) were selected as the disease control group.Sixty-three ...

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“…Similar figures have been reported in Europe. [3][4][5][6][7][8][9] COST OF COELIAC DISEASE Definitive diagnosis of coeliac disease requires an endoscopy and tissue biopsy. To confirm improvement with the introduction of a gluten free-diet, a repeat oesophagogastro-duodenoscopy (OGD) and biopsy is advised after a year of treatment.…”

Section: Epidemiologymentioning

confidence: 99%