IgA endomysium antibodies: an early predictor for celiac disease in children without villous atrophy

Grodzinsky, Ewa,1958-Linköpings universitet,Östergötlands Läns Landsting,Forsknings- och utvecklingsenheten för Närsjukvården i Östergötland,Hälsouniversitetet (author)

IgA endomysium antibodies : an early predictor for celiac disease in children without villous atrophy

Aim: To evaluate possible differences between children with anti-endomysium antibodies (EMA) positivity and normal small bowel mucosa and children with positive EMA and an enteropathy diagnosed as celiac disease (CD).Methods: Children with suspected CD and positive EMA (≥1/10) undergoing small bowel biopsy during 1996 to 2002, were investigated (n = 133). Data registered were: year and month of birth, timing of the first biopsy, sex, heredity for CD, dermatitis herpetiformis and diabetes mellitus and outcome of the anti-gliadin antibody test (AGA). The case group, with EMA positivity and normal histology (n = 39; 59% female, mean age at the first biopsy 7.3 years, range 1.4–16), was compared with the disease control group, with positive EMA and a biopsy suggestive and further on diagnosed as CD (n = 94; 56% female; mean age 7.6 years at the first biopsy, range 0.70–17).Results: AGA positivity and heredity for CD were found to predict the outcome of a pathological jejunal mucosa. Nineteen of the 39 children in the case group were rebiopsied of whom 11 had developed an enteropathy during a follow-up period of 2–7 years (median 4.5 years).Conclusions: EMA positivity in the absence of small bowel enteropathy could be a very early predictor for later overt CD, and necessitates further follow-up, especially if the child is AGA positive and there is a family history of CD.

Fälth-Magnusson, Karin,1949-Linköpings universitet,Pediatrik,Hälsouniversitetet(Swepub:liu)karfa12 (author)
Högberg, Lotta,1960-Norrköping Hospital, Norrköping, Sweden(Swepub:liu)lotho28 (author)
Jansson, GunnarMotala Hospital, Motala, Sweden (author)
Laurin, Pia,1969-Linköpings universitet,Pediatrik,Hälsouniversitetet(Swepub:liu)piala63 (author)
Stenhammar, Lars,1939-Linköpings universitet,Pediatrik,Hälsouniversitetet(Swepub:liu)larst66 (author)
Östergötlands Läns LandstingForsknings- och utvecklingsenheten för Närsjukvården i Östergötland (creator_code:org_t)

By the author/editor: Grodzinsky, Ewa, ...; Fälth-Magnusson, ...; Högberg, Lotta, ...; Jansson, Gunnar; Laurin, Pia, 196 ...; Stenhammar, Lars ...

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