GASTROENTEROLOGY ARTICLE OF THE WEEK
January 6, 2011
Leffler DA, Schuppan D. Update on serologic testing in celiac disease. Am J Gastroenterol 2010;105:2520-2524
1. What percent of celiac disease patients have co-existent IgA deficiency?
a. 5%
b. 10%
c. 15%
d. 2%
True or False
2. Deamidated gliadin peptide antibodies have similar sensitivity and specificity as anti-gliadin antibodies
3. Serologic testing for celiac disease is not an accurate marker for diet adherence
TTG antibodies have higher sensitivity and similar specificity as EMA
4. IgA anti-gliadin antibodies have a higher sensitivity than IgG antibodies
5. IgA-TTG is a better test than deaminated gliadin peptide antibodies
6. In patients with low levels of total IgA, the accuracy of IgA based tests is not compromised
7. Treatment is recommended for patients with positive celiac serology and minimal duodenal findings (Marsh I), based on natural history data suggesting benefit
8. A positive TTG-IgA should be confirmed with an IgA-EMA test
9. If an individual is IgA deficient (undetectable levels), IgG or IgG +IgA anti-deaminated gliadin testing is an accurate alternative test.