ABSTRACT
A number of techniques for the detection of anti wheat, antigluten, and antigliadin antibodies (AGA) that have been used to screen sera of patients with celiac disease have also been used to examine sera of patients with dermatitis herpetiformis. Recently, new immunofluorescence, enzyme-linked immunosorbent assay (ELISA), and radioimmunoassay (RIA) tests have become available. ELISA methods have been used by several investigators to measure gluten and gliadin antibodies in celiac disease and dermatitis herpetiformis, and recently a commercial test measuring IgA-class antibodies has also become available. In routine screening for gluten-sensitive enteropathy (GSE), the cut-off level of AGA based on 95th percentile results in healthy controls seems acceptable and has been used in most recent AGA ELISA studies. The AGA-ELISA test is also useful to monitor patients who continue on a normal diet. Increasing AGA levels indicate that the jejunal mucosa is reverting to more severe atrophy with the concomitant risk of developing nutritional deficiencies caused by malabsorption.
