Document Detail


Discrepancies between histology and serology for the diagnosis of coeliac disease in a district general hospital: is this an unrecognised problem in other hospitals?
MedLine Citation:
PMID:  19728508     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The objective of this study was to assess the increasing number of patients with positive biopsies yet negative serology at Medway Hospital, Kent, through a retrospective data collection. All coeliac serology undertaken between 2003-5 (n=3056) with coeliac positive duodenal biopsy results (n=26) were compared. From the total number of patients with positive duodenal biopsies 10 (38.5%), 13 (50%) and 12 (46.2%) had negative anti-tTg, IgA anti-gliadin and IgG anti-gliadin serology respectively. When combining anti-tTG, IgG and IgA anti-gliadin to improve sensitivity, five patients (19.2%) had completely negative and six (23%) had equivocal serology results. This study shows that a small but significant number of cases of coeliac disease will be missed by relying on serology alone. As the diagnosis and management of disease shifts further towards general physicians and primary care, it is important that the limitations of serological testing are recognised.
Authors:
Rami Sweis; Leon Pee; Gray Smith-Laing
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Publication Detail:
Type:  Case Reports; Comparative Study; Journal Article    
Journal Detail:
Title:  Clinical medicine (London, England)     Volume:  9     ISSN:  1470-2118     ISO Abbreviation:  Clin Med     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-09-04     Completed Date:  2009-09-22     Revised Date:  2010-04-22    
Medline Journal Info:
Nlm Unique ID:  101092853     Medline TA:  Clin Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  346-8     Citation Subset:  IM    
Affiliation:
St. Thomas' Hospital, London.
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MeSH Terms
Descriptor/Qualifier:
Antibodies, Anti-Idiotypic / analysis*,  immunology
Biopsy / methods*
Celiac Disease / diagnosis*,  immunology
Diagnosis, Differential
Duodenum / pathology*
Hospitals, District*
Hospitals, General*
Humans
Immunoglobulin A / immunology
Immunoglobulin G / immunology
Male
Middle Aged
Serologic Tests / methods*
Chemical
Reg. No./Substance:
0/Antibodies, Anti-Idiotypic; 0/Immunoglobulin A; 0/Immunoglobulin G
Comments/Corrections
Comment In:
Clin Med. 2010 Feb;10(1):98; author reply 99   [PMID:  20408323 ]
Clin Med. 2010 Feb;10(1):98-9; author reply 99   [PMID:  20411615 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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