Significance of Assessing of Serological Markers in Patients with CeliacDisease

Overview

Background.
Coeliac disease is presently considered to be an autoimmune disorder. Basis for the diagnosis is theinvasive histochemical examination of the intestinal biopsy. Pathologic changes are classified into three gradesaccording to the villous atrophy. Due to the autoimmune process, the patients serum levels of the specific andnonspecific antibodies, more which easily accessible to investigation, are increase.Methods and Results. One hundred thirty six probands (32 with coeliakia, 72 with other gastrointestinal disordersand 32 healthy ones) were included into the study. The antiendomysial, antireticular and antigliadin antibodies wereexamined. Results were compared with the histological finding in the gut sample. The highest sensitivity was foundfor antigliadin IgA antibodies (81 %) and antiendomysial antibodies (75 %). High specificity of the reaction inhealthy subjects as well as in those with other gastrointestinal disorders (up to 100 %), was found for antiendomysialand antireticular antibodies.Conclusions. The most appropriet screening test the diagnosis of coeliac disease, appears to be the examinationof the antigliadin antibodies of the class IgA and that of antiendomysial antibodies. On the basis of serology, today’shigh rate of underdiagnosing the disease can be prevented. However, the tests cannot differentiate between differentdegrees of the histological damage of the gut.

Key words:
coeliac disease, intestinal biopsy, antiendomysial, antireticular and antigliadin antibodies.