[Antiendomysium antibodies in the diagnosis and follow-up of celiac disease]. / Utilità degli anticorpi antiendomisio nella diagnosi e nel follow up della malattia celiaca.

ABSTRACT

The authors have studied the proceeding of anti endomysium antibodies (AEA-IgA) in a group of coeliac patients, in order to investigate new tests, not intrusive and easy repeatable, to employ in diagnosis and in follow up of coeliac disease. The research was carried out by an indirect immunofluorescent test on 65 sera of patients with age range 1-11 years; of those patients 14 show the coeliac disease at beginning, 16 were on Gluten Free Diet (GFD) from 3-5 months, 28 were on GFD from 1 year and 7 were on challenge with gluten from 2-4 months. We investigated AEA-IgA in sera of 71 gastroenterological and not-gastroenterological patients of analogous age to coeliacs how control subjects. All coeliac patients (14) with disease at beginning were positive for AEA-IgA. For the patients on GFD we observed an evident correlation between the term of diet and presence of AEA-IgA 12 of 16 patients on GFD from 3-5 months were positive, but after 1 year of GFD all patients were negative; after 2-4 months from reintroduction of gluten in diet with the challenge we observed that all examined patients were positive for AEA-IgA. In 21 coeliac patients on free diet (14 with the disease at beginning and 7 after challenge) any reduction of percentage positivity was noted with the growth. The investigation of AEA-IgA in all examined control subjects was always negative. Our data suggest that the AEA-IgA investigation, for highly sensitivity and specificity, for easy repeatability and absence of intrusivity, is a diagnostic test that can be usefully combined to others (intestinal biopsy, dosage of anti gliadin antibodies) in diagnosis and in follow up of coeliac disease.