Celiac Sprue: Likelihood Ratios

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

[Edit Diagnosis] [Merge dx] [Add prevalence]

Tags: Autoimmune Gastrointestinal Problem Tag this Diagnosis.

Prevalence

The likelihood ratios of findings for Celiac Sprue are listed below. See the left navigation bar to change the display.

Good Positive and Negative Likelihood Ratios

Finding	+LR	-LR	Comments, Study
Antigliadin Antibody Duplicate	94	0.1	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	45	0.1	(IgA) ? bias of population for specificity Study: Arch Dis Child 1991 Aug;66(8):941-7. PMID 1819255
Anti-Tissue Transglutaminase	15.8	0.1	IgA; (sens/spec per UpToDate) Study: Gastroenterology 1998 Dec;115(6):1322-8. PMID 9834257
Antigliadin Antibody Duplicate	8.5	0.2	IgA; first-generation. Study: from UpToDate: http://www.utdol.com/online/content/topic.do?topicKey=mal_synd/2879
Antigliadin Antibody Duplicate	4.4	0.2	IgG; first-generation. Study: from UpToDate: http://www.utdol.com/online/content/topic.do?topicKey=mal_synd/2879

Findings With Unspecified Accuracy

Finding	+LR	-LR	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