Mascart-Lemone F, Lambrechts A
Department of Immunology, Université Libre de Bruxelles, Brussels.
Acta Gastroenterol Belg. 1995 Sep-Dec;58(5-6):388-96.
Sera from 88 patients with untreated coeliac disease (54 children and 34 adults), 127 disease controls and 69 healthy controls were tested for anti-gliadin IgA and IgG and anti-endomysium IgA in order to determine the best serological test or the best combination of tests to pick up all the coeliac patients. Only a combination of anti-gliadin IgG and of anti-endomysium IgA affords a 100% sensitivity for coeliac disease. If anti-gliadin IgA was added to the tests, the specificity of the combination gets higher in case of positive anti-gliadin IgA. It appears therefore that it is possible to detect the atypical cases of coeliac disease by a serological screening. This is of major interest in order to begin early dietary treatment of these patients to avoid the development of malignant disorders. The final diagnosis of coeliac disease must however always rely on the results of a small intestinal biopsy.
检测了88例未经治疗的乳糜泻患者（54名儿童和34名成人）、127名疾病对照者和69名健康对照者的血清中的抗麦醇溶蛋白IgA和IgG以及抗肌内膜IgA，以确定用于检出所有乳糜泻患者的最佳血清学检测方法或最佳检测组合。只有抗麦醇溶蛋白IgG和抗肌内膜IgA的组合对乳糜泻具有100%的敏感性。如果在检测中加入抗麦醇溶蛋白IgA，在抗麦醇溶蛋白IgA呈阳性的情况下，该组合的特异性会更高。因此，似乎可以通过血清学筛查来检测乳糜泻的非典型病例。这对于尽早开始这些患者的饮食治疗以避免恶性疾病的发生至关重要。然而，乳糜泻的最终诊断始终必须依靠小肠活检的结果。
