Further screening in Libyan childhood coeliac; A practical diagnostic approach

Original article


Abdurauf M. Zagdani, Rabia M. Gwedar, Fauzi A. Sagher

Department of Paediatric Gastroenterology, TMC, Tripoli, Libya

JMJ Vol. 4, No. 1 (Summer 2005): 36-38


The search for a suitable, reliable and non- invasive serologic test is worth-while in order to develop a uniform practical approach. Serum Samples from fifty patients, of whom thirty six were active Coeliac , Ten known Coeliac on Gluten free diet for at least one year, and Twenty Control, were Screened for Antiendomysium and Anti-Gliadin Antibodies using standard techniques. Sensitivity of Antiendomysium , Anti-gliadin antibodies IgA and IgG were (88.8%, 71.4%& 80% respectively). Specificity were (92.8% , 58.3% & 81.8% respectively). Positive predictive value for anti-edomysium was 88.8 %. Diagnostic accuracy was 90% .In conclusion ; IgA deficient children or children aged 4years or less, jejunal biopsy remains the standard for diagnosis .Children over 4 years with normal Total IgA, antiendoysum IgA antibody is diagnostic of Coeliac disease . Jejunal biopsy is reserved only for clinically non-responder or persistent positive anti-endomysium IgA antibody .i.e “non-compliance “.

Keywords: childrenhood coeliac – Antigliadin Antibodies – Antiendomysium IgA – Jejunal biopsy , practical diagnosis

Link/DOI: http://www.jmj.org.ly/modules.php?name=News&file=article&sid=7