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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.

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Finding SensitivitySpecificity Comments, Study
Anti-Tissue Transglutaminase Edit 95%94%

IgA; (sens/spec per UpToDate)

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

Antiendomysial Antibody Edit 90%98%

(IgA)

? bias of population for specificity

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

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

Antigliadin Antibody
Duplicate Edit
85%90%

IgA; first-generation.

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

Antigliadin Antibody
Duplicate Edit
80%82%

IgG; first-generation.

Study: from UpToDate: http://www.utdol.com/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

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