Individual research recommendation details

Recommendation ID

NG20/1

Question

Serological testing in people who have IgA deficiency:- What is the sensitivity and specificity of IgG tissue transglutaminase (tTG), IgG endomysial antibodies (EMA) and IgG deamidated gliadin peptide (DGP) tests in detecting coeliac disease in people with IgA deficiency?

Any explanatory notes
(if applicable)

Why this is important:- IgA deficiency is significantly more common in people with coeliac disease than in the general population. People with IgA deficiency will have a false negative result when tested for IgA antibody, which may lead to a missed diagnosis of coeliac disease. A missed diagnosis may result in increased use of NHS resources and the person experiencing the risks associated with undiagnosed coeliac disease. IgG antibodies are recommended for use in place of IgA antibodies in people who have IgA deficiency, but there is limited evidence to demonstrate the sensitivity and specificity of tests for IgG antibodies – that is, IgG tTG, IgG EMA and IgG DGP – in people suspected of having coeliac disease with IgA deficiency.

 

Source guidance details

Comes from guidance

Coeliac disease: recognition, assessment and management

Number

NG20

Date issued

September 2015

Other details