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- Title
IgA endomysium antibodies – an early predictor for celiac disease in children without villous atrophy.
- Authors
Grodzinsky, E.; Fälth-Magnusson, K.; Högberg, L.; Jansson, G.; Laurin, P.; Stenhammar, L.
- Abstract
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.
- Subjects
CELIAC disease in children; IMMUNOGLOBULINS; PEDIATRIC gastroenterology; MUSCULAR atrophy in children; ENDOMYCES; MUCOUS membranes; DIARRHEA; DIGESTIVE system diseases; PEDIATRICS
- Publication
Acta Paediatrica, 2008, Vol 97, Issue 7, p972
- ISSN
0803-5253
- Publication type
Article
- DOI
10.1111/j.1651-2227.2008.00881.x