How do I interpret a positive test for anti-gliadin antibodies?
These tests are not well standardized, so interpreting the results may be difficult. A positive IgG anti-gliadin antibody is found in about 30% or more of normal individuals, and indicates gliadin in the diet. It is also positive in individuals with celiac disease. It is sensitive, but not specific. A positive IgA anti-gliadin is more sensitive and specific for celiac disease, but tissue transglutaminase is clearly better. Is a biopsy mandatory for making a diagnosis of celiac disease? We still recommend a biopsy to confirm the diagnosis of celiac disease. We will NOT make the diagnosis without biopsy confirmation. It is important to know that the biopsy excludes other causes for the signs or symptoms. In fact, about 5% of cases in which the patient and the physician feel celiac disease is present, actually have other explanations for the signs or symptoms. Celiac disease may be present in some of these patients, but asymptomatic. In addition, false positive screening tests (especially
