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Elevation of IgG antibodies against tissue transglutaminase as a diagnostic tool for coeliac disease in selective IgA deficiency.
Gut 2003; 52(11):1567-71Gut

Abstract

BACKGROUND

IgA serum autoantibodies against tissue transglutaminase (tTG) have an established diagnostic value in coeliac disease, and high efficacy tests are widely available for their detection. However, serological evaluation of IgA deficient subjects is still difficult.

AIMS

To evaluate the diagnostic potential of IgG class anti-tTG autoantibodies measured quantitatively using an enzyme linked immunosorbent assay (ELISA) compared with immunofluorescent detection of coeliac autoantibodies.

PATIENTS

We tested serum samples from 325 IgA deficient subjects, including 78 patients with coeliac disease, 73 disease controls, and 174 blood donors.

METHODS

IgG antibodies against human recombinant tTG were measured with an ELISA. IgG antiendomysium antibodies (EMA) were assayed by indirect immunofluorescence on human jejunum and appendix sections.

RESULTS

The IgG anti-tTG ELISA had a sensitivity of 98.7% and a specificity of 98.6%, and the correlation with IgG EMA titres was high (r(s)=0.91). One coeliac patient, initially negative in all autoantibody tests, displayed both IgG anti-tTG antibodies and IgG EMA during later gluten exposure. IgG anti-tTG antibodies and EMA titres showed significant decreases (p<0.001) in treated patients. The frequency of IgG anti-tTG autoantibody positivity was 9.8% among IgA deficient blood donors and 11 of the 12 positive subjects with known HLA-DQ haplotypes carried DQ2 or DQ8 alleles.

CONCLUSIONS

IgG anti-tTG and IgG EMA autoantibody tests are highly efficient in detecting coeliac disease in IgA deficient patients. The high prevalence of coeliac antibodies among symptom free IgA deficient blood donors who also carry coeliac-type HLA-DQ genes indicates that all IgA deficient persons should be evaluated for coeliac disease.

Authors+Show Affiliations

Department of Gastroenterology-Nephrology, Heim Pál Children's Hospital, Budapest, Hungary. Ilma.Korponay-Szabo@uta.fiNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Studies
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

14570724

Citation

Korponay-Szabó, I R., et al. "Elevation of IgG Antibodies Against Tissue Transglutaminase as a Diagnostic Tool for Coeliac Disease in Selective IgA Deficiency." Gut, vol. 52, no. 11, 2003, pp. 1567-71.
Korponay-Szabó IR, Dahlbom I, Laurila K, et al. Elevation of IgG antibodies against tissue transglutaminase as a diagnostic tool for coeliac disease in selective IgA deficiency. Gut. 2003;52(11):1567-71.
Korponay-Szabó, I. R., Dahlbom, I., Laurila, K., Koskinen, S., Woolley, N., Partanen, J., ... Hansson, T. (2003). Elevation of IgG antibodies against tissue transglutaminase as a diagnostic tool for coeliac disease in selective IgA deficiency. Gut, 52(11), pp. 1567-71.
Korponay-Szabó IR, et al. Elevation of IgG Antibodies Against Tissue Transglutaminase as a Diagnostic Tool for Coeliac Disease in Selective IgA Deficiency. Gut. 2003;52(11):1567-71. PubMed PMID: 14570724.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Elevation of IgG antibodies against tissue transglutaminase as a diagnostic tool for coeliac disease in selective IgA deficiency. AU - Korponay-Szabó,I R, AU - Dahlbom,I, AU - Laurila,K, AU - Koskinen,S, AU - Woolley,N, AU - Partanen,J, AU - Kovács,J B, AU - Mäki,M, AU - Hansson,T, PY - 2003/10/23/pubmed PY - 2004/1/14/medline PY - 2003/10/23/entrez SP - 1567 EP - 71 JF - Gut JO - Gut VL - 52 IS - 11 N2 - BACKGROUND: IgA serum autoantibodies against tissue transglutaminase (tTG) have an established diagnostic value in coeliac disease, and high efficacy tests are widely available for their detection. However, serological evaluation of IgA deficient subjects is still difficult. AIMS: To evaluate the diagnostic potential of IgG class anti-tTG autoantibodies measured quantitatively using an enzyme linked immunosorbent assay (ELISA) compared with immunofluorescent detection of coeliac autoantibodies. PATIENTS: We tested serum samples from 325 IgA deficient subjects, including 78 patients with coeliac disease, 73 disease controls, and 174 blood donors. METHODS: IgG antibodies against human recombinant tTG were measured with an ELISA. IgG antiendomysium antibodies (EMA) were assayed by indirect immunofluorescence on human jejunum and appendix sections. RESULTS: The IgG anti-tTG ELISA had a sensitivity of 98.7% and a specificity of 98.6%, and the correlation with IgG EMA titres was high (r(s)=0.91). One coeliac patient, initially negative in all autoantibody tests, displayed both IgG anti-tTG antibodies and IgG EMA during later gluten exposure. IgG anti-tTG antibodies and EMA titres showed significant decreases (p<0.001) in treated patients. The frequency of IgG anti-tTG autoantibody positivity was 9.8% among IgA deficient blood donors and 11 of the 12 positive subjects with known HLA-DQ haplotypes carried DQ2 or DQ8 alleles. CONCLUSIONS: IgG anti-tTG and IgG EMA autoantibody tests are highly efficient in detecting coeliac disease in IgA deficient patients. The high prevalence of coeliac antibodies among symptom free IgA deficient blood donors who also carry coeliac-type HLA-DQ genes indicates that all IgA deficient persons should be evaluated for coeliac disease. SN - 0017-5749 UR - https://www.unboundmedicine.com/medline/citation/14570724/Elevation_of_IgG_antibodies_against_tissue_transglutaminase_as_a_diagnostic_tool_for_coeliac_disease_in_selective_IgA_deficiency_ L2 - http://gut.bmj.com/cgi/pmidlookup?view=long&amp;pmid=14570724 DB - PRIME DP - Unbound Medicine ER -