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Screening for celiac disease in non-Hodgkin's lymphoma patients: a serum anti-transglutaminase-based approach.
Dig Dis Sci 2003; 48(8):1530-6DD

Abstract

Several studies have shown the existence of an association between celiac disease (CD) and non-Hodgkin's lymphoma (NHL). Our aim was to evaluate the usefulness of the serum anti-tissue transglutaminase (anti-tTG) antibody assay in screening for CD in consecutive NHL patients. In all, 80 consecutive patients (median age 61 years) with a new diagnosis of NHL were included. To compare the frequency of CD and of positive results for the anti-tTG assay, we enrolled 500 blood donors. In all patients serum anti-tTG was determined with two different ELISA: one based on tTG from guinea pig (gp-tTG) and the other based on human recombinant t-TG (h-tTG) as the antigens. Serum anti-endomysial antibodies (EmA) were also assayed. Subjects with positive serum EmA and/or anti-tTG underwent intestinal biopsy for histology study, HLA-DQ phenotype determination, and serum anti-gliadin (AGA) assay. Eight of 80 (10%) NHL patients were positive for anti-tTG ELISA--two of these exclusively for anti-gp-tTG and six for anti-h-tTG (7.5%). None of the 80 NHL patients were positive for serum EmA. The frequency of anti-tTG positivity in the blood donor controls was 2/500 (0.4%), significantly lower than that observed in the NHL patients (P < 0.0001). Both these blood donors were found to have CD. Only in one anti-h-tTG-positive NHL patient was there intestinal mucosa atrophy, and follow-up confirmed a CD diagnosis (CD frequency in NHL patients is 1.2%; versus blood donors: P = 0.4). In all the other seven anti-tTG-positive NHL patients a normal intestinal architecture was found, although, inflammatory infiltration of the lamina propria was observed in four patients. No anti-tTG-positive NHL patients, including the subject diagnosed as having CD, had a family history of CD, and all had normal weight and no signs of malabsorption. Anti-tTG false positive results were associated with a higher frequency of serum autoantibody positivity and T-cell type NHL. In conclusion, NHL patients the anti-tTG assay often gives discordant data with the EmA assay, with a high frequency of anti-tTG false positive results for CD diagnosis.

Authors+Show Affiliations

Department of Internal Medicine, University Hospital of Palermo, Palermo, Italy.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12924648

Citation

Carroccio, Antonio, et al. "Screening for Celiac Disease in non-Hodgkin's Lymphoma Patients: a Serum Anti-transglutaminase-based Approach." Digestive Diseases and Sciences, vol. 48, no. 8, 2003, pp. 1530-6.
Carroccio A, Iannitto E, Di Prima L, et al. Screening for celiac disease in non-Hodgkin's lymphoma patients: a serum anti-transglutaminase-based approach. Dig Dis Sci. 2003;48(8):1530-6.
Carroccio, A., Iannitto, E., Di Prima, L., Cirrincione, S., Troncone, R., Paparo, F., ... Notarbartolo, A. (2003). Screening for celiac disease in non-Hodgkin's lymphoma patients: a serum anti-transglutaminase-based approach. Digestive Diseases and Sciences, 48(8), pp. 1530-6.
Carroccio A, et al. Screening for Celiac Disease in non-Hodgkin's Lymphoma Patients: a Serum Anti-transglutaminase-based Approach. Dig Dis Sci. 2003;48(8):1530-6. PubMed PMID: 12924648.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Screening for celiac disease in non-Hodgkin's lymphoma patients: a serum anti-transglutaminase-based approach. AU - Carroccio,Antonio, AU - Iannitto,Emilio, AU - Di Prima,Lidia, AU - Cirrincione,Sonia, AU - Troncone,Riccardo, AU - Paparo,Franco, AU - Trapani,Lydia Gianni, AU - Gucciardi,Antonio, AU - Averna,Maurizio R, AU - Montalto,Giuseppe, AU - Notarbartolo,Alberto, PY - 2003/8/20/pubmed PY - 2003/9/10/medline PY - 2003/8/20/entrez SP - 1530 EP - 6 JF - Digestive diseases and sciences JO - Dig. Dis. Sci. VL - 48 IS - 8 N2 - Several studies have shown the existence of an association between celiac disease (CD) and non-Hodgkin's lymphoma (NHL). Our aim was to evaluate the usefulness of the serum anti-tissue transglutaminase (anti-tTG) antibody assay in screening for CD in consecutive NHL patients. In all, 80 consecutive patients (median age 61 years) with a new diagnosis of NHL were included. To compare the frequency of CD and of positive results for the anti-tTG assay, we enrolled 500 blood donors. In all patients serum anti-tTG was determined with two different ELISA: one based on tTG from guinea pig (gp-tTG) and the other based on human recombinant t-TG (h-tTG) as the antigens. Serum anti-endomysial antibodies (EmA) were also assayed. Subjects with positive serum EmA and/or anti-tTG underwent intestinal biopsy for histology study, HLA-DQ phenotype determination, and serum anti-gliadin (AGA) assay. Eight of 80 (10%) NHL patients were positive for anti-tTG ELISA--two of these exclusively for anti-gp-tTG and six for anti-h-tTG (7.5%). None of the 80 NHL patients were positive for serum EmA. The frequency of anti-tTG positivity in the blood donor controls was 2/500 (0.4%), significantly lower than that observed in the NHL patients (P < 0.0001). Both these blood donors were found to have CD. Only in one anti-h-tTG-positive NHL patient was there intestinal mucosa atrophy, and follow-up confirmed a CD diagnosis (CD frequency in NHL patients is 1.2%; versus blood donors: P = 0.4). In all the other seven anti-tTG-positive NHL patients a normal intestinal architecture was found, although, inflammatory infiltration of the lamina propria was observed in four patients. No anti-tTG-positive NHL patients, including the subject diagnosed as having CD, had a family history of CD, and all had normal weight and no signs of malabsorption. Anti-tTG false positive results were associated with a higher frequency of serum autoantibody positivity and T-cell type NHL. In conclusion, NHL patients the anti-tTG assay often gives discordant data with the EmA assay, with a high frequency of anti-tTG false positive results for CD diagnosis. SN - 0163-2116 UR - https://www.unboundmedicine.com/medline/citation/12924648/Screening_for_celiac_disease_in_non_Hodgkin's_lymphoma_patients:_a_serum_anti_transglutaminase_based_approach_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&amp;PAGE=linkout&amp;SEARCH=12924648.ui DB - PRIME DP - Unbound Medicine ER -