<<Disclaimer: Verify this information before applying it to your situation.>> Any comments on this? I received this from one of the autism lists I belong to. Vicki << Medscape Home Site Map Marketplace My Medscape CME Center Feedback Help Desk Two Assays Are Better Than One For Diagnosis of Celiac Disease -------------------------------------------------------------------- WESTPORT, Jul 08 (Reuters Health) - Serologic assays for antigliadin antibodies (AGA) and antiendomysium antibodies (EMA), when used in combination, are highly sensitive and specific for the initial diagnosis of celiac disease, Canadian investigators have found. "[T]he relative advantages of AGA versus EMA assays, their use independently or in combination, and their value as an adjunct to small-bowel biopsy are still debated," Dr. Pierre A. Russo and colleagues from Hopital Ste-Justine and the University of Montreal, Quebec, write in the journal Pediatrics for July. In a prospective, comparative analysis of the two assays, Dr. Russo's team found it most effective to combine the two. A combination of AGA and EMA assays "...resulted in 100% sensitivity and 100% negative predictive value, [and is] useful in selecting patients for duodenal biopsy," they report. Their study involved 95 pediatric patients with suspected celiac disease referred for duodenal biopsy. Twenty-four of these patients had celiac disease "...by criteria of the European Society for Pediatric Gastroenterology and Nutrition. Because neither test alone had a specificity of 100%, Dr. Russo's group recommends small-bowel biopsy to confirm a diagnosis of celiac disease, "...given the lifelong implications of following a strict gluten-free diet." Furthermore, the investigators say, the combined use of AGA and EMA permits physicians to "...select patients for confirmatory biopsy when either test is positive." When both tests are negative, physicians may "...reconsider the investigation, delay the biopsy, or simply follow the patients...given the negative predictive value of 100%." Pediatrics 1999;104:75-78.>>