| Discrepancies between histology and serology for the diagnosis of coeliac disease in a district general hospital: is this an unrecognised problem in other hospitals? | |
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MedLine Citation:
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PMID: 19728508 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Rami Sweis; Leon Pee; Gray Smith-Laing |
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Publication Detail:
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Type: Case Reports; Comparative Study; Journal Article |
Journal Detail:
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Title: Clinical medicine (London, England) Volume: 9 ISSN: 1470-2118 ISO Abbreviation: Clin Med Publication Date: 2009 Aug |
Date Detail:
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Created Date: 2009-09-04 Completed Date: 2009-09-22 Revised Date: 2010-04-22 |
Medline Journal Info:
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Nlm Unique ID: 101092853 Medline TA: Clin Med Country: England |
Other Details:
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Languages: eng Pagination: 346-8 Citation Subset: IM |
Affiliation:
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St. Thomas' Hospital, London. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Antibodies, Anti-Idiotypic
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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:
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0/Antibodies, Anti-Idiotypic; 0/Immunoglobulin A; 0/Immunoglobulin G |
| Comments/Corrections | |
Comment In:
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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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