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Just noticed that the link I listed in my last post won't work.  I guess this
is because it is too long???

Anyhow, I have copied the abstract below.  The important part is the last
line, as a lot of it might not make sense to those unfamiliar with all the
celiac jargon.  I have copied out a number of the medical research articles
for my eldest son's paediatrician, whom we saw yesterday.  The doctor is now
very keen on my son being biopsied for celiac, along with other gastro
testing, even though his celiac bloodwork reads negative.    Up until now he
has been saying that my son's illness "is all in his head" blah, blah.  But
now that his weight is officially off the percentile chart (last year the
doctor weighed him with his shoes and added a few pounds on as well to get him
on the chart), and his BMI (body mass index) is way below the chart and we now
have two in the family with celiac, the doctor's view has changed.

Article follows, and as I mentioned before, there are many others with similar
research results.

Best wishes,
Barbara, Mum of Claire 10

        1: Scand J Gastroenterol. 2001 May;36(5):511-4. Related Articles,

  Sensitivity of serum tissue transglutaminase antibodies for endomysial
antibody positive and negative coeliac disease.

  Dickey W, McMillan SA, Hughes DF.

  Dept. of Gastroenterology, Altnagelvin Hospital, Londonderry, Northern
Ireland, UK. email @ redacted

  BACKGROUND: Serum antibodies to tissue transglutaminase (tTGA) are reported
to have high sensitivity and specificity for coeliac disease and to correlate
closely with endomysial antibodies (EmA). We assessed their performance in a
coeliac population with a high proportion of EmA-negative patients, who have
been under-represented in previous studies. METHODS: We used a commercial
ELISA kit to test for IgA class tTGA in sera from a population of 73 untreated
coeliac patients with normal serum IgA and a high percentage (19%)
EmA-negative, taking 58 patients with normal duodenal biopsies as controls.
EmA was measured using indirect immunofluorescence. RESULTS: Forty-six (63%)
patients with villous atrophy (VA) had both tTGA and EmA. However, when
considered separately, sensitivities of tTGA and EmA for VA were similar (75%
versus 81%) and both had high specificity (98% versus 97%). As 9 patients were
tTGA-positive only and 13 had EmA only, selection of patients for biopsy on
the presence of either antibody would have had a sensitivity of 93% (68 of
73), with 5 (7%) patients seronegative for both. CONCLUSION: Although the
ELISA tTGA assay is more convenient than EmA testing, it offers no advantages
in sensitivity or specificity if used in isolation. However, incomplete
concordance between EmA and tTGA positivity means that combination screening
with both assays offers higher sensitivity, as almost a third of patients have
only one antibody. As some coeliac patients with normal serum IgA are negative
for both antibodies, biopsies should still be performed in seronegative
individuals deemed at high risk for coeliac disease.

  PMID: 11346205 [PubMed - indexed for MEDLINE]

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