Serologic markers of untreated celiac disease in Libyan children: antigliadin, antitransglutaminase, antiendomysial, and anticalreticulin antibodies

J Pediatr Gastroenterol Nutr. 2001 Sep;33(3):276-82. doi: 10.1097/00005176-200109000-00009.


Background: There are, as yet, no data available about the incidence of celiac disease in Libya. The aim of this study was to test the occurrence of serologic markers in a group of Libyan children with positive clinical and histologic findings indicative of celiac disease diagnosis.

Methods: Thirty-nine children with untreated celiac disease and 50 healthy school children, all younger than 14 years, were included in the study. Enzyme-linked immunosorbent assay for immunoglobulin G and immunoglobulin A (IgA) antigliadin, antitissue transglutaminase, and anticalreticulin antibodies was used to evaluate the serologic markers of the celiac patients. Immunoglobulin A antiendomysial antibodies were detected by indirect immunofluorescence using human umbilical cord tissue.

Results: Clinical symptoms at presentation were weight loss (82%), abdominal distension (61.5%), diarrhea or steatorrhea (59%), pallor (41%), abdominal pain (20.5%), constipation (15%), vomiting (10%), and short stature (7.7%). Most of these symptoms disappeared after introduction of a gluten-free diet. Of 39 patients, only 23 (59%) were endomysium positive and positive also in all other serologic markers. The second group of patients with positive clinical and biopsy findings but antiendomysial antibody-negative findings was subdivided into two subgroups according to the IgA antigliadin antibody results. Individuals in the IgA gliadin-negative subgroup also lacked IgA autoantibodies.

Conclusions: The authors' findings stress the importance of serologic testing not only for screening but also for confirmation of celiac disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Autoantibodies / blood*
  • Autoantibodies / immunology
  • Biomarkers / blood
  • Calcium-Binding Proteins / immunology*
  • Calreticulin
  • Celiac Disease / blood*
  • Celiac Disease / diagnosis
  • Celiac Disease / epidemiology
  • Celiac Disease / immunology
  • Child
  • Diet
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Fluorescent Antibody Technique, Indirect
  • Gliadin / immunology*
  • Glutens / administration & dosage
  • Humans
  • Immunoglobulin A / immunology
  • Immunoglobulin G / immunology
  • Incidence
  • Jejunum / pathology
  • Libya / epidemiology
  • Male
  • Ribonucleoproteins / immunology*
  • Transglutaminases / immunology*


  • Autoantibodies
  • Biomarkers
  • Calcium-Binding Proteins
  • Calreticulin
  • Immunoglobulin A
  • Immunoglobulin G
  • Ribonucleoproteins
  • Glutens
  • Gliadin
  • Transglutaminases