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Section 2
Published in Padmanabhan Ramnarayan, MCQs in Paediatrics for the MRCPCH, Part 1, 2017
Establishing the diagnosis of coeliac disease is possible only with jejunal biopsy/positive IgA anti-endomysial antibodies. The rest of the tests suggest either malabsorption (72-hour faecal fat) or are non-specific (anti-gliadin antibodies). False-negative results from an antibody screen to endomysial antibodies will result from IgA deficiency, so make sure to check immunoglobulin levels if in doubt.
Nutrition and Mental Health
Published in Mary J. Marian, Gerard E. Mullin, Integrating Nutrition Into Practice, 2017
Celiac panel with antigliadin antibodies (IgG, secretory IgA), HLA DQ2 and DQ8 (only a positive response is helpful; too many false negatives); anti-IgA tissue transglutaminase antibodies, endomysium antibodies. None of these tests, however, is definitive, so the entire clinical picture must be considered.
Relation of Antigliadin Antibodies to Gluten-Sensitive Enteropathy
Published in Tadeusz P. Chorzelski, Ernst H. Beutner, Vijay Kumar, Tadeusz K. Zalewski, Serologic Diagnosis of Celiac Disease, 2020
Wim Th. J. M. Hekkens, Marja van Twist - de Graaf
Besides, the definition “gluten-free”, as described in the Codex Standard for Gluten-Free Foods, may not solve but rather aggrevate the problems of industry. According to this standard a product is gluten-free when “the total nitrogen content of the gluten-containing cereal grains used in the product does not exceed 0.05 g per 100 g of these grains on a dry matter basis”.21 However, the analysis of the nitrogen content is not the method of choice for the determination of prolamins in cereals and in cereal-containing products; even more important, the gliadin content in most cases is not related to the nitrogen content. A method to control the gluten-free state of food products will be required because the overproduction of cereals forces the industry to search for further uses of grain derivatives. Many products will be supplemented with starch or proteins, either in the native form or as hydrolyzed (and otherwise formed) derivatives. Several methods have been developed to determine the cereal prolamins in food and beverages. Electrophoresis has been used for qualitative and quantitative analysis. Immunochemical assays in various forms have been developed of which radioimmunoassay (RIA) and ELISA are the quantitative methods of choice. These methods make use of antigliadin antibodies to detect gliadin in food extracts. However, when products which contain substances of various cereals are analyzed, the results can be influenced by cross-reactivity of the antigliadin antibodies with other prolamins. In such cases the immunoblotting method is useful to determine the exact composition of the product. Several methods are discussed here.
Serologic Testing for Celiac Disease in Graves’ Hyperthyroidism: Should We Act Early?
Published in Endocrine Research, 2022
Hande Demirdere, Ozge Telci Caklili, Sema Yarman
IgA and IgG antigliadin antibodies (IgA-AGA, IgG-AGA) were measured by enzyme linked immunosorbent assay (ELISA) (The Binding Site Ltd., Birmingham, United Kingdom). The results were expressed in arbitrary units per liter and were classified as positive or negative based on the results of healthy blood donors. IgA endomysium antibodies (EMAs) were determined after incubation of serum with primate esophagus tissue by indirect immunofluorescence, and the serum samples were evaluated for the presence of IgA-EmA by an indirect immunofluorescence assay with monkey esophagus tissue (The Binding Site Ltd., Birmingham, United Kingdom). Samples that showed fluorescence at a dilution of 1:10 were considered positive and were subsequently tested at higher dilutions. The sensitivity of this assay varies from 73.3% to 87% according to screening method whereas specificity is ≈ 98%.15 IgA anti-tissue transglutaminase (IgA anti-tTG) was considered positive ≥20 unit/mL with ELISA (The Binding Site Ltd., Birmingham, United Kingdom). The sensitivity and specificity of this test were reported as 96% and 97%, respectively.16 Serum IgA was measured using rate nephelometry (Beckman Coulter, UK). Samples with an IgA value <0.1 g/L were excluded from the study. All sera were examined under same diagnostic conditions at the clinical microbiology and immunology laboratory of Istanbul University Hospital with the same assays which were purchased by the authors with the project budget.
A review on the relationship between gluten and schizophrenia: Is gluten the cause?
Published in Nutritional Neuroscience, 2018
Can Ergün, Murat Urhan, Ahmet Ayer
Although there are a great number of studies analyzing the relationship between schizophrenia and celiac disease, the mechanisms of the common ground between these two diseases are still unknown. Recent trials show that these two diseases share similar genetic regions regarding gluten. Nevertheless, the results of immunological studies revealed that the anti-gliadin immune response in schizophrenia has different antigenic specificity from celiac disease. And although most of the schizophrenic patients with increased anti-gliadin antibodies do not have celiac disease, the presence of increased antibodies against gluten is the shared point of immunological abnormalities found in both of the diseases.
Evaluation of Ocular Parameters in Adult Patients with Celiac Disease
Published in Current Eye Research, 2021
Leyla Hazar, Gülistan Oyur, Kadri Atay
Celiac-specific antibodies, including anti-tTG IgA and EmA IgA and IgA and IgG deamidated gliadin peptide antibodies are important for the diagnosis of celiac disease.3 Notably, anti-tTG IgA antibodies and EmA of the IgA class have high accuracy for diagnosing celiac disease, and antibody concentrations are correlated with the degree of mucosal inflammation.24 Despite the higher sensitivity and specificity of anti-tTG IgA and EmA IgA, primary pediatricians and gastroenterologists include AGA IgA testing as part of celiac disease serology in screening panels.3