Tags

Type your tag names separated by a space and hit enter

Antiendomysial antibody test reliability in children with frequent diarrhea and malnutrition: is it celiac disease?
J Pediatr Gastroenterol Nutr 2001; 33(4):483-7JP

Abstract

BACKGROUND

The aim of this study was to evaluate the specificity of the immunoglobulin A (IgA) antiendomysial antibody test in the diagnosis of celiac disease in a group of malnourished children with acute diarrhea, chronic diarrhea, or parasitosis, because the reliability of this test has been questioned when applied to this specific group of patients.

METHODS

Serum IgA level, IgA antiendomysial antibody (EMA) test, and stool examination were performed in 315 children, ranging in age 6 months to 13 years (range, 41 +/- 2.9 months), affected by malnutrition, isolated or in association with diarrhea or parasitosis. Independent of results, 33 children with a strong suspicion of celiac disease, also underwent IgA antitransglutaminase antibody test and jejunal biopsy.

RESULTS

The EMA test was negative in 313 children, including the 43 with parasitosis, being positive in two patients in whom biopsy disclosed typical celiac mucosal abnormalities (1:157). The 31 children with negative EMA test who underwent biopsy also showed negative antitransglutaminase antibody results. Their biopsies disclosed normal mucosa in 1 patient, variable degree of jejunal atrophy (grade 1 and 2) in 27 patients, and grade 3 abnormalities in 3 patients. One of these three children, showing severe jejunal atrophy, died. The diagnosis of celiac disease was apparently not confirmed by a protracted gluten challenge in the other two children.

CONCLUSIONS

The specificity of the EMA test seems to be high also in children with chronic malnutrition and diarrhea. However, the possibility of false-negative tests among immunologically compromised children cannot be excluded. In doubtful cases, the gluten challenge is required in malnourished children with clinical picture, biopsy finding, and evolution suggestive of celiac disease.

Authors+Show Affiliations

Department of Pediatrics, University of Brasilia School of Medicine, Brasilia, Brazil.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

11698768

Citation

Gandolfi, L, et al. "Antiendomysial Antibody Test Reliability in Children With Frequent Diarrhea and Malnutrition: Is It Celiac Disease?" Journal of Pediatric Gastroenterology and Nutrition, vol. 33, no. 4, 2001, pp. 483-7.
Gandolfi L, Catassi C, Garcia S, et al. Antiendomysial antibody test reliability in children with frequent diarrhea and malnutrition: is it celiac disease? J Pediatr Gastroenterol Nutr. 2001;33(4):483-7.
Gandolfi, L., Catassi, C., Garcia, S., Modelli, I. C., Campos, D., & Pratesi, R. (2001). Antiendomysial antibody test reliability in children with frequent diarrhea and malnutrition: is it celiac disease? Journal of Pediatric Gastroenterology and Nutrition, 33(4), pp. 483-7.
Gandolfi L, et al. Antiendomysial Antibody Test Reliability in Children With Frequent Diarrhea and Malnutrition: Is It Celiac Disease. J Pediatr Gastroenterol Nutr. 2001;33(4):483-7. PubMed PMID: 11698768.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antiendomysial antibody test reliability in children with frequent diarrhea and malnutrition: is it celiac disease? AU - Gandolfi,L, AU - Catassi,C, AU - Garcia,S, AU - Modelli,I C, AU - Campos,D,Jr AU - Pratesi,R, PY - 2001/11/8/pubmed PY - 2002/4/18/medline PY - 2001/11/8/entrez SP - 483 EP - 7 JF - Journal of pediatric gastroenterology and nutrition JO - J. Pediatr. Gastroenterol. Nutr. VL - 33 IS - 4 N2 - BACKGROUND: The aim of this study was to evaluate the specificity of the immunoglobulin A (IgA) antiendomysial antibody test in the diagnosis of celiac disease in a group of malnourished children with acute diarrhea, chronic diarrhea, or parasitosis, because the reliability of this test has been questioned when applied to this specific group of patients. METHODS: Serum IgA level, IgA antiendomysial antibody (EMA) test, and stool examination were performed in 315 children, ranging in age 6 months to 13 years (range, 41 +/- 2.9 months), affected by malnutrition, isolated or in association with diarrhea or parasitosis. Independent of results, 33 children with a strong suspicion of celiac disease, also underwent IgA antitransglutaminase antibody test and jejunal biopsy. RESULTS: The EMA test was negative in 313 children, including the 43 with parasitosis, being positive in two patients in whom biopsy disclosed typical celiac mucosal abnormalities (1:157). The 31 children with negative EMA test who underwent biopsy also showed negative antitransglutaminase antibody results. Their biopsies disclosed normal mucosa in 1 patient, variable degree of jejunal atrophy (grade 1 and 2) in 27 patients, and grade 3 abnormalities in 3 patients. One of these three children, showing severe jejunal atrophy, died. The diagnosis of celiac disease was apparently not confirmed by a protracted gluten challenge in the other two children. CONCLUSIONS: The specificity of the EMA test seems to be high also in children with chronic malnutrition and diarrhea. However, the possibility of false-negative tests among immunologically compromised children cannot be excluded. In doubtful cases, the gluten challenge is required in malnourished children with clinical picture, biopsy finding, and evolution suggestive of celiac disease. SN - 0277-2116 UR - https://www.unboundmedicine.com/medline/citation/11698768/Antiendomysial_antibody_test_reliability_in_children_with_frequent_diarrhea_and_malnutrition:_is_it_celiac_disease L2 - http://Insights.ovid.com/pubmed?pmid=11698768 DB - PRIME DP - Unbound Medicine ER -