Original Articles: Clinical Studies: PDF OnlyGliadin-Specific Serum Immunoglobulins A, E, G, and M in Childhood Relation to Small Intestine Mucosal MorphologyJuto, Per; Fredrikzon, Bo*; Hernell, Olle* Author Information Departments of Virology and *Pediatrics, University of Umeå, Umeå, Sweden Journal of Pediatric Gastroenterology and Nutrition: October 1985 - Volume 4 - Issue 5 - p 723-729 Free Abstract Summary:An enzyme-linked immunosorbent assay technique was developed to determine serum antigliadin antibodies of the IgA, IgE, IgG, and IgM classes. The antibody level of each serum specimen was expressed as an index value, i.e., optical density of test serum/optical density of cutoff, where cutoff was calculated for each immunoglobulin class as the mean + 3 SD for six healthy controls. Indices for each immunoglobulin class were determined in 69 children who were admitted for their first small intestinal mucosal biopsy due to either symptoms of malabsorption compatible with celiac disease, or short stature without other symptoms. Especially raised levels of antigliadin IgA antibodies in serum correlated strongly with villous atrophy and in infants ≤3 years of age were invariably elevated above controls, provided they were on a gluten-containing diet. Raised levels of IgG and IgE antibodies to gluten were often seen in children with normal mucosal morphology, i.e., when symptoms were due to other gastrointestinal disorders than celiac disease. It is concluded that determination of antigliadin IgA antibodies in children ≤3 years is a useful screening test before small intestinal biopsy, especially in children where the indication for biopsy is not otherwise obvious. The method can also be used to assess the results of therapy and, conceivably, compliance. © Lippincott-Raven Publishers.