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Hi All,
I thought there might be some interest in the following abstract:

J Pediatr Gastroenterol Nutr 1999 Jan;28(1):26-30
High prevalence of silent celiac disease in preschool children screened
with IgA/IgG antiendomysium antibodies.
Korponay-Szabo IR, Kovacs JB, Czinner A, Goracz G, Vamos A, Szabo T
Department of Gastroenterology-Nephrology, Heim Pal Children's Hospital,
Budapest, Hungary.

BACKGROUND: Because of the different sensitivity and specificity of
serologic tests, the search for silent celiac disease is usually performed
with the combined or sequential use of several tests. Among these, the
IgA-class endomysium antibody test has the highest specificity and positive
predictive value, but it may overlook IgA-deficient patients. METHODS: To
test a new one-step screening approach, serum samples from 427 apparently
healthy, 3- to 6-year-old Hungarian children were investigated for
IgA-class and IgG-class endomysium antibodies using monkey esophagus and
human jejunum as substrates. RESULTS: Five new cases with flat mucosa were
identified by strong endomysium antibody positivity and subsequent jejunal
biopsy, yielding a celiac disease prevalence of 1:85. An additional child
may have latent celiac disease (slight histologic changes at present). Two
of the screening-detected celiac patients exhibited only IgG-class
endomysium antibodies due to associated IgA-deficiency. Despite the young
age of the screened population, antigliadin antibodies were positive in
only three of the five celiac patients. CONCLUSIONS: Prevalence of celiac
disease in the study population was much higher than expected on the basis
of antigliadin antibody-based studies. The screening system used detected
celiac cases in which there was IgA-deficiency and those in which there was
not and also those negative for antigliadin antibodies. The findings
suggest the importance of the primary testing of autoantibodies in future
celiac disease screening policies.