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Antiendomysium antibodies in Brazilian patients with celiac disease and their first-degree relatives.

Abstract

BACKGROUND

Literature data have shown high specificity of antiendomysial antibodies (EmA IgA) in celiac disease. The scarcity of Brazilian reports concerning this subject motivated the present study.

OBJECTIVES

To determine the sensitivity and specificity of antiendomysial IgA antibodies in Brazilian celiac patients at diagnosis and after treatment, to confirm patient adherence to a gluten-free diet and to screen first-degree relatives.

METHODS

An extensive clinical and serological study was performed by investigating the presence of these antibodies in 392 individuals from Southern Brazil. Indirect immunofluorescence using human umbilical cord as substrate was employed and the total levels of IgA were determined by turbidimetry in all groups. The study was conducted on 57 celiac patients (18 at diagnosis, 24 who adhered to a gluten-free diet and 15 with marked or slight transgression of the diet), 115 relatives of celiac patients (39 families), 94 patients with other gastrointestinal diseases, and 126 healthy individuals from the general population.

RESULTS

The results demonstrated 100% positivity for the recently diagnosed patients and for those consuming gluten, in contrast to the patients who complied with the diet (0%). In the control group one individual was positive, but refused to undergo a biopsy. In the group of other gastrointestinal diseases, one positive patient presented ulcerative colitis, Down's syndrome and epilepsy, and the intestinal biopsy was diagnostic for celiac disease. These data showed 99.3% specificity for the test. Eighteen relatives were positive for antiendomysial antibodies IgA (15.65%), and comparison with the healthy population revealed a significant difference. An intestinal biopsy was obtained from seven subjects (one with total villous atrophy and six without alterations in the mucosal architecture, but all with a high number of intra-epithelial lymphocytes).

CONCLUSIONS

The method revealed 100% sensitivity and 99.3% specificity. Because it is not an invasive method it can be used for the screening of atypical and latent forms of celiac disease to avoid serial biopsies and to control adherence to a gluten-free diet with implications in the prevention of malignancy in celiac disease.

Authors+Show Affiliations

,

Service of Gastroenterology and Digestive Endoscopy, Hospital Cajuru Service of Gastroenterology, Federal University of Paraná, Curitiba, PR, Brazil. loretekotze@hotmail.com

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Source

MeSH

Adolescent
Adult
Aged
Autoantibodies
Case-Control Studies
Celiac Disease
Chi-Square Distribution
Child
Child, Preschool
Confidence Intervals
Family
Female
Fluorescent Antibody Technique, Indirect
Genetic Predisposition to Disease
Humans
Immunoglobulin A
Infant
Infant, Newborn
Male
Middle Aged
Sensitivity and Specificity

Pub Type(s)

Journal Article

Language

eng

PubMed ID

11793949

Citation

Kotze, L M., et al. "Antiendomysium Antibodies in Brazilian Patients With Celiac Disease and Their First-degree Relatives." Arquivos De Gastroenterologia, vol. 38, no. 2, 2001, pp. 94-103.
Kotze LM, Utiyama SR, Nisihara RM, et al. Antiendomysium antibodies in Brazilian patients with celiac disease and their first-degree relatives. Arq Gastroenterol. 2001;38(2):94-103.
Kotze, L. M., Utiyama, S. R., Nisihara, R. M., Zeni, M. P., de Sena, M. G., & Amarante, H. M. (2001). Antiendomysium antibodies in Brazilian patients with celiac disease and their first-degree relatives. Arquivos De Gastroenterologia, 38(2), pp. 94-103.
Kotze LM, et al. Antiendomysium Antibodies in Brazilian Patients With Celiac Disease and Their First-degree Relatives. Arq Gastroenterol. 2001;38(2):94-103. PubMed PMID: 11793949.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antiendomysium antibodies in Brazilian patients with celiac disease and their first-degree relatives. AU - Kotze,L M, AU - Utiyama,S R, AU - Nisihara,R M, AU - Zeni,M P, AU - de Sena,M G, AU - Amarante,H M, PY - 2002/1/17/pubmed PY - 2002/2/2/medline PY - 2002/1/17/entrez SP - 94 EP - 103 JF - Arquivos de gastroenterologia JO - Arq Gastroenterol VL - 38 IS - 2 N2 - BACKGROUND: Literature data have shown high specificity of antiendomysial antibodies (EmA IgA) in celiac disease. The scarcity of Brazilian reports concerning this subject motivated the present study. OBJECTIVES: To determine the sensitivity and specificity of antiendomysial IgA antibodies in Brazilian celiac patients at diagnosis and after treatment, to confirm patient adherence to a gluten-free diet and to screen first-degree relatives. METHODS: An extensive clinical and serological study was performed by investigating the presence of these antibodies in 392 individuals from Southern Brazil. Indirect immunofluorescence using human umbilical cord as substrate was employed and the total levels of IgA were determined by turbidimetry in all groups. The study was conducted on 57 celiac patients (18 at diagnosis, 24 who adhered to a gluten-free diet and 15 with marked or slight transgression of the diet), 115 relatives of celiac patients (39 families), 94 patients with other gastrointestinal diseases, and 126 healthy individuals from the general population. RESULTS: The results demonstrated 100% positivity for the recently diagnosed patients and for those consuming gluten, in contrast to the patients who complied with the diet (0%). In the control group one individual was positive, but refused to undergo a biopsy. In the group of other gastrointestinal diseases, one positive patient presented ulcerative colitis, Down's syndrome and epilepsy, and the intestinal biopsy was diagnostic for celiac disease. These data showed 99.3% specificity for the test. Eighteen relatives were positive for antiendomysial antibodies IgA (15.65%), and comparison with the healthy population revealed a significant difference. An intestinal biopsy was obtained from seven subjects (one with total villous atrophy and six without alterations in the mucosal architecture, but all with a high number of intra-epithelial lymphocytes). CONCLUSIONS: The method revealed 100% sensitivity and 99.3% specificity. Because it is not an invasive method it can be used for the screening of atypical and latent forms of celiac disease to avoid serial biopsies and to control adherence to a gluten-free diet with implications in the prevention of malignancy in celiac disease. SN - 0004-2803 UR - https://www.unboundmedicine.com/medline/citation/11793949/Antiendomysium_antibodies_in_Brazilian_patients_with_celiac_disease_and_their_first_degree_relatives_ L2 - http://www.diseaseinfosearch.org/result/1186 DB - PRIME DP - Unbound Medicine ER -