| Title | Antibodies against human tissue transglutaminase and endomysium in diagnosing and monitoring coeliac disease. | | Author(s) | Bürgin-Wolff A, Dahlbom I, Hadziselimovic F, Petersson CJ | | Institution | Institute for Coeliac Disease, Liestal, Switzerland. a.buergin-wolff@bluewin.ch | | Source | Scand J Gastroenterol 2002 Jun; 37(6):685-91. | | MeSH | Adolescent
Adult
Aged
Autoantibodies
Case-Control Studies
Celiac Disease
Child
Child, Preschool
Comparative Study
Diet
Enzyme-Linked Immunosorbent Assay
Female
Fluorescent Antibody Technique, Indirect
Follow-Up Studies
Humans
Immunoglobulin A
Male
Middle Aged
Monitoring, Physiologic
Probability
Prospective Studies
ROC Curve
Reference Values
Sensitivity and Specificity
Transglutaminases
| | Abstract | BACKGROUND: Coeliac disease (CD) patients often present a variety of uncharacteristic symptoms and therefore sensitive and specific screening tests are needed as an aid in making an accurate diagnosis. A recently developed ELISA, using human recombinant tissue transglutaminase (tTG) as antigen, was evaluated for its significance in the diagnosis of CD. The patient's compliance to a gluten-free diet and the serological reaction during gluten challenge were also monitored. The results were compared with IgA-endomysium antibody (EMA) results.
METHODS: Sera previously collected from 365 patients (0.4-76 years) with jejunal biopsy on a gluten-containing diet and from 41 patients on a gluten-free diet or challenge were tested for IgA anti-human tTG antibodies (IgA tTG ab) with Celikey (Pharmacia Diagnostics). The study population comprised 208 CD patients and 157 controls. The diagnostic performance and cut-off for the assay were estimated with ROC analysis. EMA was analysed by indirect immunofluorescence microscopy on cryostat sections of monkey oesophagus.
RESULTS: 200/208 patients with CD had positive IgA tTG ab (median >100 U/ml), while only 1/157 of the control patients were positive (median 1.67 U/ml). The area under the ROC curve was 98.3% and the sensitivity and specificity of the test were 96% and 99% for the study population. Only 4/365 patients (1%) presented discordant IgA tTG ab and EMA results, 2 of them had only IgA tTG ab and 2 only EMA. The IgA tTG ab levels and the EMA titres were closely correlated to the duration of gluten-free diet and gluten challenge, respectively.
CONCLUSION: IgA tTG ab can be used as an accurate observer-independent alternative to EMA in diagnosing or monitoring CD. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 12126247 |
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