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Antibodies against human tissue transglutaminase and endomysium in diagnosing and monitoring coeliac disease.
Scand J Gastroenterol 2002; 37(6):685-91SJ

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.

Authors+Show Affiliations

Institute for Coeliac Disease, Liestal, Switzerland. a.buergin-wolff@bluewin.chNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

12126247

Citation

Bürgin-Wolff, A, et al. "Antibodies Against Human Tissue Transglutaminase and Endomysium in Diagnosing and Monitoring Coeliac Disease." Scandinavian Journal of Gastroenterology, vol. 37, no. 6, 2002, pp. 685-91.
Bürgin-Wolff A, Dahlbom I, Hadziselimovic F, et al. Antibodies against human tissue transglutaminase and endomysium in diagnosing and monitoring coeliac disease. Scand J Gastroenterol. 2002;37(6):685-91.
Bürgin-Wolff, A., Dahlbom, I., Hadziselimovic, F., & Petersson, C. J. (2002). Antibodies against human tissue transglutaminase and endomysium in diagnosing and monitoring coeliac disease. Scandinavian Journal of Gastroenterology, 37(6), pp. 685-91.
Bürgin-Wolff A, et al. Antibodies Against Human Tissue Transglutaminase and Endomysium in Diagnosing and Monitoring Coeliac Disease. Scand J Gastroenterol. 2002;37(6):685-91. PubMed PMID: 12126247.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antibodies against human tissue transglutaminase and endomysium in diagnosing and monitoring coeliac disease. AU - Bürgin-Wolff,A, AU - Dahlbom,I, AU - Hadziselimovic,F, AU - Petersson,C J, PY - 2002/7/20/pubmed PY - 2003/1/11/medline PY - 2002/7/20/entrez SP - 685 EP - 91 JF - Scandinavian journal of gastroenterology JO - Scand. J. Gastroenterol. VL - 37 IS - 6 N2 - 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. SN - 0036-5521 UR - https://www.unboundmedicine.com/medline/citation/12126247/Antibodies_against_human_tissue_transglutaminase_and_endomysium_in_diagnosing_and_monitoring_coeliac_disease_ L2 - http://www.tandfonline.com/doi/full/10.1080/00365520212496 DB - PRIME DP - Unbound Medicine ER -