THE ROLE OF ANTI-ENDOMYSIUM ANTIBODIES IN THE SCREENING AND FOLLOW-UP OF CELIAC-DISEASE

We have used a serological test for IgA anti-endomysial antibodies (AEA) by indirect immunofluorescence to evaluate the clinical usefulness of this new marker of celiac disease. We studied sera of 31 active cases of celiac disease; we studied also the sera of 9 cases after 6 months and 10 cases after 12 months of gluten free diet (GFD); in 11 patients the serum determination was performed during the gluten challenge. IgA-AEA was also determined in 83 children with various affections. Our research for AEA showed positive results in all celiac children at presentation and in challenge. Eight of 9 patients on GFD for 6 months were also found to exhibit AEA. Among the celiac patients on GFD for 1 year, only in one case were detected IgA-AEA: this case referred to a young girl admitting to poor compliance with GFD. None of the patients with other disease had IgA-AEA. We deem it useful to emphasise the specificity and sensitivity of anti-endomysial antibodies for celiac disease. In our opinion the AEA assay represents the most effective means to perform a screening for CD today; moreover the decrease of AEA titer after the introduction of a GFD is a useful indicator of whether an individual patient is following the dietary recommendations.