Immunofluorescent antibodies against gliadin: a screening test for coeliac disease.

A sensitive and simple immunofluorescence test for gliadin antibodies is described, which may be suitable as a screening method for coeliac disease especially in cases with no clear-cut indication for performing a biopsy. In serum samples of 19 from 23 patients (83%) with coeliac disease proved by biopsy antibodies against gliadin could be detected. In a control group of 71 children in whom the clinical diagnosis of another malabsorptive disorder was made gliadin-IF-antibodies were found in only 3 children (4%). With better timing of blood sampling (first sample during a period with gluten containing food and in case of a negative result a second sample after 4-8 days of gluten withdrawal) the sensitivity of the screening test will be improved. The described gliadin-IF-test permits the classification of the antibodies into the different immunoglobulin classes. In each child with a positive result IgG antibodies against gliadin were detected. In 9 respectively 4 of the 19 patients with IgG antibodies IgA- respectively IgM-antibodies against gliadin were also found. Antibodies against at least one cow milk protein were identified in nearly all (91%) coeliac patients and in half (49%) of the patients with other malabsorptive disorders.