Carroccio A, Iacono G, Montalto G, Cavataio F, Soresi M, Kazmierska I, Notarbartolo A
IInd Dept. of Medical Pathology, University of Palermo, Italy.
Scand J Gastroenterol. 1993 Aug;28(8):673-6. doi: 10.3109/00365529309098270.
The sensitivity and specificity of several immunologic and absorption tests were determined in infants with celiac disease (31 male, 39 female; median age, 2.6 years) in different phases of the disease and in a group of control subjects with chronic diarrhea of different etiologies (32 male, 28 female; median age, 1.2 years). Intestinal biopsy was performed both in the patients and in the controls as a 'gold standard' for the diagnosis. The anti-gliadin antibody (AGA) IgG values showed a sensitivity of 89% and a specificity of 47%; AGA IgA were 69% sensitive and 92% specific; anti-endomysial antibodies (EmA) were 100% sensitive and 97% specific; the xylose test was 71% sensitive and 53% specific; and the steatocrit test after a standard fatty meal was 73% sensitive and 42% specific. The authors conclude that the absorption tests cannot be used successfully in screening for celiac disease, owing to their low specificity. In contrast, EmA behavior was always in accordance with histologic findings in the various phases of celiac disease, and we would advise their use combined with AGA to obtain a sensitivity and specificity of 100%.
在患有乳糜泻的婴儿（31名男性，39名女性；中位年龄2.6岁）疾病的不同阶段以及一组患有不同病因慢性腹泻的对照受试者（32名男性，28名女性；中位年龄1.2岁）中，测定了几种免疫和吸收试验的敏感性和特异性。对患者和对照者均进行了肠道活检，作为诊断的“金标准”。抗麦醇溶蛋白抗体（AGA）IgG值的敏感性为89%，特异性为47%；AGA IgA的敏感性为69%，特异性为92%；抗肌内膜抗体（EmA）的敏感性为100%，特异性为97%；木糖试验的敏感性为71%，特异性为53%；标准脂肪餐后的脂肪含量测定试验的敏感性为73%，特异性为42%。作者得出结论，由于吸收试验的特异性较低，因此不能成功用于乳糜泻的筛查。相比之下，EmA的表现始终与乳糜泻不同阶段的组织学结果一致，我们建议将其与AGA联合使用，以获得100%的敏感性和特异性。
