Table of Contents Author Guidelines Submit a Manuscript
Canadian Journal of Gastroenterology
Volume 25, Issue 4, Pages 193-197
http://dx.doi.org/10.1155/2011/642452
Review

Testing for Gluten-Related Disorders in Clinical Practice: The Role of Serology in Managing the Spectrum of Gluten Sensitivity

David Armstrong,1 Andrew C Don-Wauchope,2 and Elena F Verdu1

1Farncombe Family Digestive Health Research Institute and Division of Gastroenterology, Canada
2Department of Pathology and Molecular Medicine and Department of Medicine, McMaster University, Hamilton, Ontario, Canada

Received 6 October 2010; Accepted 10 October 2010

Copyright © 2011 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Immunoglobulin A tissue transglutaminase is the single most efficient serological test for the diagnosis of celiac disease. It is well known that immunoglobulin A tissue transglutaminase levels correlate with the degree of intestinal damage, and that values can fluctuate in patients over time. Serological testing can be used to identify symptomatic individuals that need a confirmatory biopsy, to screen at-risk populations or to monitor diet compliance in patients previously diagnosed with celiac disease. Thus, interpretation of serological testing requires consideration of the full clinical scenario. Antigliadin tests are no longer recommended for the diagnosis of classical celiac disease. However, our understanding of the pathogenesis and spectrum of gluten sensitivity has improved, and gluten-sensitive irritable bowel syndrome patients are increasingly being recognized. Studies are needed to determine the clinical utility of antigliadin serology in the diagnosis of gluten sensitivity.