Celiac Sprue: Sensitivity and Specificity

Introduction: also called gluten-sensitive enteropathy and nontropical sprue.

Diagnostic algorithms outlined in UpToDate article: http://www.utdol.com/online/content/topic.do?topicKey=malsynd/2879

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Tags: Autoimmune Gastrointestinal Problem Tag this Diagnosis.

Prevalence

The sensitivity and specificity of findings for Celiac Sprue are listed below. See the left navigation bar to change the display.

Sensitive and Specific Findings

Finding	Sensitivity	Specificity	Comments, Study
Antigliadin Antibody Duplicate	94%	99%	second generation (AGA II). First-gen test has poor sens/spec. Study: UpToDate: http://www.utdol.com/online/content/topic.do?topicKey=mal_synd/2879
Antiendomysial Antibody	90%	98%	(IgA) ? bias of population for specificity Study: Arch Dis Child 1991 Aug;66(8):941-7. PMID 1819255
Anti-Tissue Transglutaminase	95%	94%	IgA; (sens/spec per UpToDate) Study: Gastroenterology 1998 Dec;115(6):1322-8. PMID 9834257
Antigliadin Antibody Duplicate	85%	90%	IgA; first-generation. Study: from UpToDate: http://www.utdol.com/online/content/topic.do?topicKey=mal_synd/2879

Poorly Diagnostic Findings

Finding	Sensitivity	Specificity	Comments, Study
Antigliadin Antibody Duplicate	80%	82%	IgG; first-generation. Study: from UpToDate: http://www.utdol.com/online/content/topic.do?topicKey=mal_synd/2879

Findings With Unspecified Accuracy

Finding	Sensitivity	Specificity	Comments, Study
Small bowel biopsy	No accuracy specified.		need to take multiple biopsies from 2nd and 3rd portions of duodenum Study: from UpToDate: http://www.utdol.com.laneproxy/online/content/topic.do?topicKey=mal_synd/2879
Diarrhea	No accuracy specified.		sensitivity and specificity highly variable depending on study - data in meta-analysis cited below Study: JAMA 2010 v303(17):1738