Antibodies to gliadin as a screening test for coeliac disease. A prospective study
Signer, E.; Bürgin-Wolff, A.; Berger, R.; Birbaumer, A.; Just, M.
Helvetica Paediatrica Acta 34(1): 41-52
1979
ISSN/ISBN: 0018-022X PMID: 372144 Document Number: 150079
The diagnostic value of estimating gliadin antibodies using the fluorescent immunosorbent test was examined in a prospective study of 57 children with gastrointestinal disease. Antibodies were found in all 20 patients with active coeliac disease, whereas 7 of these children had a normal xylose absorption test despite a flat small gut mucosa. Only 4 of 28 children with other gastrointestinal conditions had antibodies to gliadin, invariably in low titre. After at least 2 years on a gluten-free diet none of 9 children with coeliac disease in remission had demonstrable gliadin antibodies. The gliadin antibodies disappear slowly, within 6 to 24 months, after withdrawal of gliadin from the diet. Of 606 healthy children, adolescents and adults 5 had gliadin antibodies in low titre. Increased mean cow's milk antibody titres were demonstrable in 8 of 20 patients with active coeliac disease and in 9 of 28 patients with other gastrointestinal lesions. Estimation of circulating gliadin antibodies is considered a worthwhile screening test in suspected coeliac disease. In patients so selected there is a definite indication for small intestinal biopsy to confirm the diagnosis.