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Diagnosing celiac disease: a comparison of human tissue transglutaminase antibodies with antigliadin and antiendomysium antibodies.
Arch Pediatr Adolesc Med 2004; 158(6):584-8AP

Abstract

OBJECTIVE

To evaluate and compare the sensitivity and specificity of the new serologic marker human antitissue transglutaminase antibodies (IgA anti-tTG) with those of antiendomysium (IgA EMA) and antigliadin antibodies (IgA and IgG AGA) for the diagnosis of celiac disease (CD).

METHODS

The level of IgA antibodies to tTG in serum was determined by an enzyme-linked immunosorbent assay (ELISA) test using recombinant human tTG as the antigen; IgA EMA, by indirect immunofluorescence; and IgA and IgG AGA, by ELISA. Sixty-eight serum samples from 59 patients with CD were studied-30 patients had untreated CD, 22 were on gluten-free diets, and 16 had been reintroduced to gluten-and compared with serum samples from 116 children examined for failure to thrive, short stature, various digestive diseases, or other non-CD conditions.

RESULTS

Twenty-eight of 30 patients with CD had anti-tTG (the 2 patients whose results were negative were 1 patient with IgA deficiency and 1 infant); 27 of 30 patients had IgA EMA (1 child was IgA anti-tTG positive and IgA EMA negative); 18 of 30 had IgA AGA; and 28 of 30 had IgG AGA. On gluten-free diets, 4 of 22 patients had anti-tTG but none had IgA EMA or IgA AGA. On normal diets, 15 of 15 children who had relapsed had anti-tTG; 9, IgA EMA; 4, IgA AGA; and 8, IgG AGA (1 child did not relapse). In subjects without CD, 3 of 116 had anti-tTG; 12, IgG AGA; and 1, IgA AGA, but none had IgA EMA. In the 3 children who had anti-tTG, CD could be excluded. The positive predictive value of IgA anti-tTG was 90% and the negative predictive value, 98%. In comparison, results for IgA EMA were 100% and 97%, IgA AGA 94% and 90%, and IgG AGA 70% and 98%, respectively.

CONCLUSION

The presence of human anti-tTG is a reliable indicator for the diagnosis and follow-up of CD.

Authors+Show Affiliations

Hôpital d'Enfants Armand Trousseau, Paris, France. jean-jacques.baudon@trs.ap-hop-paris.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Validation Studies

Language

eng

PubMed ID

15184223

Citation

Baudon, Jean-Jacques, et al. "Diagnosing Celiac Disease: a Comparison of Human Tissue Transglutaminase Antibodies With Antigliadin and Antiendomysium Antibodies." Archives of Pediatrics & Adolescent Medicine, vol. 158, no. 6, 2004, pp. 584-8.
Baudon JJ, Johanet C, Absalon YB, et al. Diagnosing celiac disease: a comparison of human tissue transglutaminase antibodies with antigliadin and antiendomysium antibodies. Arch Pediatr Adolesc Med. 2004;158(6):584-8.
Baudon, J. J., Johanet, C., Absalon, Y. B., Morgant, G., Cabrol, S., & Mougenot, J. F. (2004). Diagnosing celiac disease: a comparison of human tissue transglutaminase antibodies with antigliadin and antiendomysium antibodies. Archives of Pediatrics & Adolescent Medicine, 158(6), pp. 584-8.
Baudon JJ, et al. Diagnosing Celiac Disease: a Comparison of Human Tissue Transglutaminase Antibodies With Antigliadin and Antiendomysium Antibodies. Arch Pediatr Adolesc Med. 2004;158(6):584-8. PubMed PMID: 15184223.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diagnosing celiac disease: a comparison of human tissue transglutaminase antibodies with antigliadin and antiendomysium antibodies. AU - Baudon,Jean-Jacques, AU - Johanet,Catherine, AU - Absalon,Yvan Boniface, AU - Morgant,Georges, AU - Cabrol,Sylvie, AU - Mougenot,Jean-François, PY - 2004/6/9/pubmed PY - 2004/7/9/medline PY - 2004/6/9/entrez SP - 584 EP - 8 JF - Archives of pediatrics & adolescent medicine JO - Arch Pediatr Adolesc Med VL - 158 IS - 6 N2 - OBJECTIVE: To evaluate and compare the sensitivity and specificity of the new serologic marker human antitissue transglutaminase antibodies (IgA anti-tTG) with those of antiendomysium (IgA EMA) and antigliadin antibodies (IgA and IgG AGA) for the diagnosis of celiac disease (CD). METHODS: The level of IgA antibodies to tTG in serum was determined by an enzyme-linked immunosorbent assay (ELISA) test using recombinant human tTG as the antigen; IgA EMA, by indirect immunofluorescence; and IgA and IgG AGA, by ELISA. Sixty-eight serum samples from 59 patients with CD were studied-30 patients had untreated CD, 22 were on gluten-free diets, and 16 had been reintroduced to gluten-and compared with serum samples from 116 children examined for failure to thrive, short stature, various digestive diseases, or other non-CD conditions. RESULTS: Twenty-eight of 30 patients with CD had anti-tTG (the 2 patients whose results were negative were 1 patient with IgA deficiency and 1 infant); 27 of 30 patients had IgA EMA (1 child was IgA anti-tTG positive and IgA EMA negative); 18 of 30 had IgA AGA; and 28 of 30 had IgG AGA. On gluten-free diets, 4 of 22 patients had anti-tTG but none had IgA EMA or IgA AGA. On normal diets, 15 of 15 children who had relapsed had anti-tTG; 9, IgA EMA; 4, IgA AGA; and 8, IgG AGA (1 child did not relapse). In subjects without CD, 3 of 116 had anti-tTG; 12, IgG AGA; and 1, IgA AGA, but none had IgA EMA. In the 3 children who had anti-tTG, CD could be excluded. The positive predictive value of IgA anti-tTG was 90% and the negative predictive value, 98%. In comparison, results for IgA EMA were 100% and 97%, IgA AGA 94% and 90%, and IgG AGA 70% and 98%, respectively. CONCLUSION: The presence of human anti-tTG is a reliable indicator for the diagnosis and follow-up of CD. SN - 1072-4710 UR - https://www.unboundmedicine.com/medline/citation/15184223/Diagnosing_celiac_disease:_a_comparison_of_human_tissue_transglutaminase_antibodies_with_antigliadin_and_antiendomysium_antibodies_ L2 - https://jamanetwork.com/journals/jamapediatrics/fullarticle/10.1001/archpedi.158.6.584 DB - PRIME DP - Unbound Medicine ER -