Sensibilidad y especificidad de los exámenes de anticuerpos antigliadina y antiendomisio
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Rev. bol. ped.
Abstract
La enfermedad celíaca se presenta con una gran heterogeneidad: formas sintomáticas, silentes y latentes. La determinación de anticuerpos antigliadina y antiendomisio es útil para definir a qué pacientes realizar biopsia de intestino delgado y para el seguimiento de los celíacos ya conocidos. Estas técnicas fueron incorporadas en 1994 en el Centro Hospitalario Pereira Rossell. Objetivo: conocer la sensibilidad y especificidad de los anticuerpos antigliadina (IgG) y antiendomisio (IgA) para el diagnóstico de enfermedad celíaca, determinados por técnica de inmunofluorescencia en la Sección de Inmunología del Laboratorio Central del Centro Hospitalario Pereira Rossell y aplicados a población hospitalaria. Material y método: se evaluaron los resultados de la serología tomando como patrón de oro la anatomía patológica de la biopsia de intestino delgado. Para el diagnóstico de enfermedad celíaca se siguieron los criterios de 1990 de la Sociedad Europea de Gastroenterología Pediátrica y Nutrición. Se evaluó la serología de 65 niños que recibían gluten al momento de la extracción de sangre: 50 celíacos y 15 no celíacos (con biopsia normal). Resultados: la sensibilidad y la especificidad fueron de 94% y 80% para los anticuerpos antigliadina y de 94% y 93% para los antiendomisio respectivamente. Comentarios: estos resultados son similares a los comunicados por los mejores laboratorios a nivel internacional.
Celiac disease presents a wide variety of patterns: active, silent, and latent. Antigliadin and antiendomysium antibodies are useful to select patients for small bowel biopsy and to follow up patients in whom celiac disease has already been diagnosed. Since 1994 laboratory techniques for these antibodies are being performed in the Centro Hospitalario Pereira Rossell (CHPR). Objective: to establish the sensitivity and specificity of antigliadin (IgG) and antiendomysium (IgA) antibodies performed by inmunofluorescence techniques in the Immunology Section of the Central Laboratory of CHPR, for the diagnosis of celiac disease in hospital patients. Small bowel biopsy was used as gold standard. Diagnosis of celiac disease was based on European Society of Pediatric Gastroenterology and Nutrition criteria established in 1990. Antibodies were performed in 65 children fed with gluten, 50 celiac and 15 non celiac-children ( i.e., with a normal small bowel biopsy). Sensitivity and specificity were 94% and 80% for antigliadin and 94% and 93% for antiendomysium antibodies, respectively. These findings are similar to those published by major international laboratories.
Celiac disease presents a wide variety of patterns: active, silent, and latent. Antigliadin and antiendomysium antibodies are useful to select patients for small bowel biopsy and to follow up patients in whom celiac disease has already been diagnosed. Since 1994 laboratory techniques for these antibodies are being performed in the Centro Hospitalario Pereira Rossell (CHPR). Objective: to establish the sensitivity and specificity of antigliadin (IgG) and antiendomysium (IgA) antibodies performed by inmunofluorescence techniques in the Immunology Section of the Central Laboratory of CHPR, for the diagnosis of celiac disease in hospital patients. Small bowel biopsy was used as gold standard. Diagnosis of celiac disease was based on European Society of Pediatric Gastroenterology and Nutrition criteria established in 1990. Antibodies were performed in 65 children fed with gluten, 50 celiac and 15 non celiac-children ( i.e., with a normal small bowel biopsy). Sensitivity and specificity were 94% and 80% for antigliadin and 94% and 93% for antiendomysium antibodies, respectively. These findings are similar to those published by major international laboratories.
Description
Vol. 43, No. 2