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Evidence-Based Medicine 2006;11:25; doi:10.1136/ebm.11.1.25
Copyright © 2006 by the BMJ Publishing Group Ltd.
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Diagnosis

Review: IgA endomyseal and transglutaminase antibodies had high specificity for diagnosis of coeliac disease

Rostom A, Dubé C, Cranney A, et al. The diagnostic accuracy of serologic tests for celiac disease: a systematic review. Gastroenterology 2005;128:S38–46.[CrossRef][Medline]

Q What are the test properties of antigliadin antibody (AGA), endomyseal antibody (EMA), and transglutaminase antibody (tTG) and their subtypes for diagnosis of coeliac disease in children and adults?

Clinical impact ratings Gastroenterology ******{star}

Key Words: coeliac disease • biological markers • antibodies

The first 150 words of the full text of this article appear below.

METHODS
Formula Data sources: Medline (1966 to October 2003) and EMBASE/Excerpta Medica (1974–2003).

Formula Study selection and assessment: studies that allowed extraction of sensitivity and specificity data and had no fatal methodological flaws. Exclusion criteria: control group did not receive the gold standard (biopsy), biopsy criteria not described, patient disease status for the test under consideration was known, control groups included patients with Marsh I or II biopsy lesions, or AGA tests done without a commercial ELISA kit or before 1990.

Formula Outcomes: sensitivity and specificity.

MAIN RESULTS
55 studies met the selection criteria. The tableGo summarises the sensitivity and specificity of each test by patient population.


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  		Weighted pooled sensitivity (sens) and specificity (spec) of tests for diagnosing celiac disease*
 
CONCLUSIONS
Endomyseal and transglutaminase antibodies (IgA class) had pooled sensitivities >=90% and specificities >=97% for diagnosis of coeliac disease in children or adults. Antigliadin antibody (IgA class) had sensitivities of 75–95% and specificities of 80–95%.

Author response
Although we . . . [Full text of this article]

Neil E Gibson, MD

University of Alberta, St Albert, Alberta, Canada






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Copyright © 2006 by the BMJ Publishing Group Ltd.