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Are there any unique factors to be considered for children? (I've heard that the serology has a lower predictive value for children under age two, since IgA may be depressed, or with anyone who has a condition which depresses IgA.)**
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Vijay Kumar, M.D., Research Associate Professor at the University of Buffalo and President and Director of IMMCO Diagnostics: Not really. It is not true that the serological methods have lower predictive value in children less than two years of age. In all the studies that we did, there was 100% correlation of the EMA to the disease activity irrespective of the age.
Karoly Horvath, M.D., Ph.D., Associate Professor of Pediatrics; Director, Peds GI & Nutrition Laboratory; University of Maryland at Baltimore: There are age dependent changes in several blood parameters during childhood. It is well known that immunoglobulinendomysium antibody test is less specific and sensitive in children below two years of age. They found that the sensitivity of the EmA test decreased from 98% to 88% in children younger than 2 years of age. It means that 12% of their patients with celiac disease, who were younger than two years of age, did not have an increase in their endomysium antibody levels.
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