Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
Background: Celiac disease is a common autoimmune disorder that is diagnosed based on clinical case identification, serological screening, and duodenal histology. However, the existence of mild clinical forms, such as seronegative cases with patchy atrophy and potential celiac disease, can make it difficult to determine a definitive diagnosis. The seronegative patients with celiac disease can include those with discordant antibody results and false-negative results, due to unknown origins or selective IgA deficiency. Case presentation: We present two cases with discordant antibody results in order to evaluate if the simultaneous detection of specific antibodies can improve the serodiagnosis of celiac disease. In both patients, the simultaneous detection of IgA/IgG anti-tissue transglutaminase/deamidated gliadin peptides gave discordant positive results by the same antibodies assayed individually. Conclusion: Although further studies are needed to confirm and extend our findings, the simultaneous detection of specific antibodies seems to improve the serodiagnosis of celiac disease in patients with discordant antibody results.