Serum IgA and IgG Gliadin Antibodies and Small Intestinal Mucosal Damage in Children

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Abstract
Serum immunoglobulin (Ig) A and IgG gliadin antibodies with determined with a simple, rapid, and inexpensive method.sbd.diffusion-in-gel enzyme-linked immunosorbent assay (DIG-ELISA).sbd.and the results were related to small intestinal mucosal morphology in 234 children suspected of having malabosrption. Fifty-six of 58 children with flat intestinal mucosa had increased IgA and/or IgG gliadin antibody levels (sensitivity 97%). Fifty-four of the 58 children had celiac disease (CD) (n = 25) or probable CD (n = 29). Four children with flat mucosa had cow''s milk protein and/or soy protein intolerance and three of these had increased gliadin antibody levels. Seventeen percent of 132 children with normal intestinal mucosa had increased IgA and/or IgG gliadin antibody levels. IgA and IgG gliadin antibody levels decreased significantly in the celiac children on a gluten-free diet and increased significantly after gluten challenge. Determination of serum IgA and IgG glidin antibodies by means of DIG-ELISA is a sensitive test for small intestinal mucosal damage in children. When malabsorption is supected, we suggest that this assay be used to select children for a small intestinal biopsy. It is also very useful for the follow-up of adherence to a gluten-free diet and to determine the effect of gluten challenge in celiac children.