Ca' Foncello Hospital, ULSS2 Marca Trevigiana, Treviso, Italy -
Ca' Foncello Hospital, ULSS2 Marca Trevigiana, Treviso, Italy.
Minerva Gastroenterol (Torino). 2024 Sep;70(3):291-298. doi: 10.23736/S2724-5985.23.03396-X. Epub 2023 Oct 5.
The diagnosis of celiac disease (CD) is still challenging and tests that show an activation of the immune system against gluten are required. IgA antiendomysial antibodies detection in the supernatant of intestinal biopsies by immunofluorescence technique (AEA-biopsy) is a promising diagnostic tool. The aim of the present study was to evaluate the diagnostic accuracy of AEA-biopsy in a pediatric population with suspected CD.
All children who underwent upper gastrointestinal endoscopy at the Unit of Pediatrics of Treviso Hospital were enrolled and divided into 4 groups: classical CD, CD excluded, potential CD and control group. For each patient, serum autoantibodies and histological evaluation were determined. Two additional biopsy samples were taken to test for presence of AEA.
A total of 92 patients were enrolled. All the classical CD cases (38) had a positive AEA-biopsy. In the CD excluded group (10 in total) AEA-biopsy was negative in all patients except 1. Among potential CD patients (which were 14), AEA-biopsy was negative in 4. In the control group (30 patients) AEA-biopsy was negative in all patients except 1. The sensitivity and specificity of AEA-biopsy were 100% and 96% respectively.
AEA-biopsy has an excellent diagnostic accuracy in a routine clinical setting.
乳糜泻（CD）的诊断仍然具有挑战性，需要进行能够显示针对麸质的免疫激活的检测。通过免疫荧光技术（AEA-活检）检测肠活检标本上清液中的 IgA 抗肌内膜抗体是一种很有前途的诊断工具。本研究旨在评估 AEA-活检在疑似 CD 的儿科人群中的诊断准确性。
特维索医院儿科系接受上消化道内镜检查的所有儿童均被纳入研究，并分为 4 组：经典 CD、排除 CD、潜在 CD 和对照组。对每位患者均进行血清自身抗体和组织学评估。另外采集 2 份活检样本以检测 AEA 的存在。
共纳入 92 例患者。所有经典 CD 病例（38 例）的 AEA-活检均为阳性。在排除 CD 组（共 10 例）中，除 1 例外，所有患者的 AEA-活检均为阴性。在潜在 CD 患者组（共 14 例）中，4 例患者的 AEA-活检为阴性。在对照组（30 例）中，除 1 例外，所有患者的 AEA-活检均为阴性。AEA-活检的敏感性和特异性分别为 100%和 96%。
在常规临床环境中，AEA-活检具有出色的诊断准确性。
