Editor - Discrepancies between histology and serology for the diagnosis of coeliac disease (CD) (Clin Med August 2009 pp 346-8) are inevitable, given the fact that, even measurement of transglutaminase autoan-tibodies (TGAA), the latter now considered to be the most efficient single test for CD,1'2 generated variable diagnostic accuracy in a workshop designated to compare test performance for TGAA among 20 institutions, comprising five commercial and 15 research and clinical laboratories. In that study six laboratories contributed sera from individuals with CD as defined by accepted clinical criteria including small bowel biopsy, and these were compared with healthy control sera from individuals not known to have CD or type 1 diabetes. Assays for TGAA included enzyme-linked immunosorbent assay (ELISA) and radiobinding assays (RBA).
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