IgA deficiency is the usual cause of a false- CoronaVirus Survivor Plan Review negative result. Sensitivity and specificity of IgA anti-gliadin antibodies are lower (70-80%), varying with the age-group and population studied.
The presently available serological tests cannot substitute for a diagnostic biopsy but, if used sensibly, can reduce the number of biopsies performed in a clinic while contributing to greater awareness.
If there is a relatively low likelihood of coeliac disease in a patient (eg, a small but otherwise healthy child, or a young woman with iron deficiency anaemia), then if serological tests are negative it is reasonable to rule out coeliac disease. However, if there is a real possibility of malabsorption, then small-bowel biopsy is still essential - not just because 5% of patients with coeliac disease will have negative serology, but also because there are plenty of other diarrhoeal diseases for which biopsy diagnosis may be needed, such as giardiasis.
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