Medeiros E H, Patrício F R, de Morais M B, Leser P G, Wehba J
Escola Paulista de Medicina, São Paulo.
Arq Gastroenterol. 1994 Oct-Dec;31(4):154-8.
Between July 1985 and June 1990, we prospectively investigated 236 children suspected of having malabsorption syndrome. Each patient had a xylose absorption test and small intestinal biopsy. Blood samples were collected to AGA assay. The aim of the study was to evaluate the use of antigliadin antibodies test, IgG and IgA, in screening celiac disease for intestinal biopsy and in the monitoring of gluten-free diet and challenge in celiac patients. Twenty patients were diagnosed with celiac disease confirmed by three small intestinal biopsies; 12 patients were suspected of having celiac disease, with two biopsies, before and one year after a gluten-free diet; 106 patients had environmental enteropathy; 45 patients had protracted diarrhea and 56 children had failure to thrive with no gastrointestinal symptoms. The AGA test was considered a reliable test in screening for biopsy and in the differential diagnosis between celiac disease and other causes of malabsorption syndrome. The IgG AGA test had high sensitivity (90.4%) and the IgA AGA test had high specificity (92.1%) in screening for celiac disease. In the follow-up of the celiac patients the antibody levels were significantly higher during gluten containing diet than after gluten avoidance being thus a reliable test to evaluate dietary compliance.
1985年7月至1990年6月期间，我们对236名疑似吸收不良综合征的儿童进行了前瞻性研究。每位患者均进行了木糖吸收试验和小肠活检。采集血样进行抗麦胶蛋白抗体（AGA）检测。本研究的目的是评估抗麦胶蛋白抗体检测（IgG和IgA）在筛查乳糜泻以指导小肠活检、监测乳糜泻患者无麸质饮食及激发试验中的应用。20例患者经三次小肠活检确诊为乳糜泻；12例患者在无麸质饮食前及饮食一年后经两次活检，疑似患有乳糜泻；106例患者患有环境性肠病；45例患者患有迁延性腹泻，56名儿童发育不良但无胃肠道症状。AGA检测在筛查活检以及鉴别乳糜泻和吸收不良综合征的其他病因方面被认为是一项可靠的检测。IgG AGA检测在筛查乳糜泻时具有高敏感性（90.4%），而IgA AGA检测具有高特异性（92.1%）。在乳糜泻患者的随访中，含麸质饮食期间的抗体水平显著高于避免麸质饮食后，因此是评估饮食依从性的一项可靠检测。
