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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

Population / CalculatorPrevalence Comments / Study / Link
No risk factors, United States 0.75% Arch Intern Med 2003 Feb 10;163(3):286-92. PMID 12578508
First-degree relatives 5% Arch Intern Med 2003 Feb 10;163(3):286-92. PMID 12578508
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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 SensitivitySpecificity Comments, Study
Antigliadin Antibody
Duplicate Edit
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 Edit 90%98%

(IgA)

? bias of population for specificity

Study: Arch Dis Child 1991 Aug;66(8):941-7. PMID 1819255

Anti-Tissue Transglutaminase Edit 95%94%

IgA; (sens/spec per UpToDate)

Study: Gastroenterology 1998 Dec;115(6):1322-8. PMID 9834257

Antigliadin Antibody
Duplicate Edit
85%90%

IgA; first-generation.

Study: from UpToDate: http://www.utdol.com/online/content/topic.do?topicKey=mal_synd/2879

Poorly Diagnostic Findings

Finding SensitivitySpecificity Comments, Study
Antigliadin Antibody
Duplicate Edit
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 SensitivitySpecificity Comments, Study
Small bowel biopsy Edit 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 Edit No accuracy specified.

sensitivity and specificity highly variable depending on study - data in meta-analysis cited below

Study: JAMA 2010 v303(17):1738