Which is the most sensitive and specific antibody for Celiac sprue?
Correct Answer: Anti endomysial
Description: Antibodies used in diagnosing Celiac sprue: Anti endomysial (anti EMA) - highest sensitivity and specificity, best performance for detection of celiac sprue. The antigen recognized by them is tissue transglutaminase. Anti gliadin (AGN) - variability and lower accuracy, unsuitable for diagnosis and screening. Anti reticulin (ARA) - not used routinely Anti transglutaminase (anti-Ttga) - highly sensitive and specific, but anti endomysial is more superior. Some impoant points about celiac disease: Intolerance to food containing gliadin like rye, oats, barley and wheat IgA antibodies. 95% express HLA -DQ2 allele Small intestine biopsy is characteristic but not diagnostic and shows absent or reduced height of villi, flat appearance, crypt hyperplasia, villous atrophy, but not mucosal atrophy, increased lymphocytes and plasma cells in lamina propria. Associated diseases: Dermatitis herpetiformis IgA deficiency Lymphomas Autoimmune diseases like Addison's, Diabetes mellitus. Graves, Myasthenia, Sjogren's etc.
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