Cataldo F, Trippiedi M A, Marino V, Maltese I, Traverso G, Paternostro D, Albeggiani A
Clinica Pediatrica R, Università degli Studi di Palermo.
Minerva Pediatr. 1993 Jan-Feb;45(1-2):29-33.
Anti-endomysium antibodies (AEA) and Antigliadin antibodies (AGA) have been compared in a group of coeliac patients (17 with untreated coeliac disease, 56 after gluten free diet and 14 after gluten challenge), in 69 patients with various intestinal pathological conditions, and in 40 healthy children, in order to appreciate sensitivity and specificity of these tests in diagnosis of coeliac disease. AEA and AGA IgA were detected in 100% and AGA IgG were found in 94.1% of coeliacs with untreated disease; after gluten free diet AGA IgG were found in 27.7% of cases, while AGA IgA and AEA were absent in all coeliacs but one with non correct compliance to diet. After gluten challenge followed by villous atrophy, 78.5% of patients were positive for AGA IgA, 85.71% for AGA IgG and 100% for AEA. Anti-endomysium antibodies were absent both in healthy controls both in control disease patients, while sometimes antigliadin antibodies were present in patients with various intestinal pathology (AGA IgA in 1.44% and AGA IgG in 7.2% of cases). In our experience therefore AEA, because their sensitivity and high specificity, appear to disclose new prospects in diagnosis of coeliac disease.
对一组乳糜泻患者(17例未经治疗的乳糜泻患者、56例接受无麸质饮食后的患者和14例接受麸质激发试验后的患者)、69例患有各种肠道病理状况的患者以及40例健康儿童,比较了抗肌内膜抗体(AEA)和抗麦胶蛋白抗体(AGA),以评估这些检测在乳糜泻诊断中的敏感性和特异性。在100%未经治疗的乳糜泻患者中检测到AEA IgA,在94.1%的此类患者中检测到AGA IgG;接受无麸质饮食后,27.7%的病例中检测到AGA IgG,而除1例饮食依从性不佳的乳糜泻患者外,所有患者均未检测到AGA IgA和AEA。麸质激发试验后出现绒毛萎缩,78.5%的患者AGA IgA呈阳性,85.71%的患者AGA IgG呈阳性,100%的患者AEA呈阳性。健康对照者和对照疾病患者中均未检测到抗肌内膜抗体,而在患有各种肠道病理状况的患者中有时会检测到抗麦胶蛋白抗体(1.44%的病例中AGA IgA呈阳性,7.2%的病例中AGA IgG呈阳性)。因此,根据我们的经验,由于AEA具有敏感性和高特异性,在乳糜泻诊断中似乎展现出了新的前景。