Which of the following circulating antibodies has the best sensitivity and sepcificity for the diagnosis of celiac disease ?

Ans. is 'a' i.e. Anti saccharomyces antibody Serologic evaluation in celiac disease Immunoglobulin A (IgA) anti-tissue transglutaminase (TTG) antibody is the single preferred test for detection of celiac disease in individuals over the age of two years. Serum antibody assays A variety of serologic studies have been described to aid in the diagnosis of celiac disease, including: IgA endomysial antibody (IgA EMA) IgA tissue transglutaminase antibody (IgA tTG) IgG tissue transglutaminase antibody (IgG tTG) IgA deamidated gliadin peptide (IgA DGP) IgG deamidated gliadin peptide (IgG DGP) Serum IgA endomysial and tissue transglutaminase antibody testing have the highest diagnostic accuracy. The IgA and IgG antigliadin antibody tests have lower diagnostic accuracy with frequent false positive results as compared with IgA tTG and IgA DGP assays and are therefore no longer recommended for initial diagnostic evaluation or screening However, the newer anti-deamidated gliadin peptide (DGP) assays described above show high diagnostic accuracy. IgA EMA, IgA tTG,IgA DGP and IgG DGP levels fall with treatment; as a result, these assays can be used as a noninvasive means of monitoring the response to a gluten-free diet. Assay sensitivity and specificity IgA endomysial antibodies- - Sensitivity 85 to 98 percent; specificity 97 to 100 percent IgA tissue transglutaminase antibodies - Sensitivity 90 to 98 percent; specificity 95 to 97 percent -- IgA deamidated gliadin peptide - Sen sitivity 94 percent; specificity 99 percent IgG deamidated gliadin peptide - Sensitivity 92 percent; specificity 100 percent