Gliadin Antibodies (IgG and IgA)

Immunology

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Description

Gliadins are a class of alcohol soluble protein found in the gluten of wheat, barley, rye and oat grains. Gliadin antibodies ( AGA ) are found in patients with coeliac disease and other gluten-sensitive enteropathies, such as dermatitis herpetiformis ( DH ) although they are not specific. AGA are found in other bowel disorders such as Crohn's disease, ulcerative colitis and also in children without coeliac disease. Tissue transglutaminase and anti-endomysial antibodies are now preferred tests over gliadin antibodies in the diagnosis of gluten sensitive enteropathy due to their higher sensitivity and specificity [1,2]. A deaminated gliadin peptide antibody test has been described for the diagnosis of coeliac disease but requires further evaluation [2,3].

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Indications

Coeliac Disease, Dermatitis Herpetiformis.

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Sample Type

2mL Serum ( Gel 5mL Yellow tube ). Requests from outside Sheffield: Transport at ambient temperature via Royal Mail or Courier.

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Reference Range

Negative = <7 U/mL.
Equivocal = 7.1 - 10 U/mL.
Positive = >10 U/mL.

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Turnaround Time

Within 10 days

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Testing Frequency

2 times per week

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External Notes

Endomysial antibodies and tissue transglutaminase antibodies are more sensitive and specific markers of coeliac disease. NICE guidelines do not recommend the use of gliadin antibodies in the assessment of coeliac disease [1].

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References

NICE clinical guideline 20 ( NG20 ). Coeliac disease: Recognition, assessment and management. 2015. [Ref 1]
Hopper AD, et al. What is the role of serologic testing in coeliac disease? A prospective, biopsy-confirmed study with economic analysis. Clinical Gastroenterology and Hepatology. 2008. 6:314-320. [Ref 2]
Rashtak S, et al. Comparitive usefulness of deaminated gliadin antibodies in the diagnosis of coeliac disease. Clin. Gastroenterol. Hepatol. 2008. 6( 4 ):426-432. [Ref 3]
Hopper AD, et al. Adult coeliac disease. BMJ. 2007. 335: 558-562.
Heel DA, West J. Recent advances in coeliac disease. Gut. 2006. 55:1037-1046.
Hopper AD, et al. Pre-endoscopy serological testing for coeliac disease:evaluation of a clinical decision tool. BMJ. 2007. 334:729.
Rostom A, et al. The diagnostic accuracy of serologic tests for coeliac disease: a systematic review. Gastroenterology. 2005. 128( 4 ):S38-46.

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See Also

Endomysial antibodies; tissue transglutaminase

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