ABSTRACT
This chapter affords a review of history of the diagnosis of celiac disease up to the introduction of highly specific and sensitive antibody tests for the detection of gluten-sensitive enteropathy. In light of the follow-up studies on all unexpected positives in controls, the specificity was 100% in our studies. Reports of apparent false positives based on single observations without complete documentation are open to question and should, in our opinion, be regarded as questionable cases either under investigation or lost to follow-up. The relation of the IgA-Endomysial Antibodies (EmA) titers to disease activity may be considered at two levels: a population of celiac disease cases and the individual patient. While IgA-EmA is clearly associated with villous atrophy, single titers cannot be used to assess the degree of intestinal pathology. Introduction of gluten-free diet to suspected celiac patients without previous IgA-EmA assays and/or biopsy studies still occurs, although our findings now show that this practice is contraindicated.
