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Prediction of clinical and mucosal severity of coeliac disease and dermatitis herpetiformis by quantification of IgA/IgG serum antibodies to tissue transglutaminase.
J Pediatr Gastroenterol Nutr 2010; 50(2):140-6JP

Abstract

OBJECTIVES

We analysed whether the quantification of autoantibodies against tissue transglutaminase could be used to predict mucosal destruction and disease severity in patients with gluten sensitivity.

PATIENTS AND METHODS

One hundred seventy patients with coeliac disease (CD), comprising 52 children with severe malabsorption (group I), 59 children with mild symptoms (group II), 59 adults (group III), 134 patients with dermatitis herpetiformis (DH), and 131 disease controls, were studied. Serial serum samples of patients in groups I and II on a gluten-free diet were also included. Serum levels of antibodies against recombinant tissue transglutaminase were determined with ELISA using standard curves for quantification of antibodies.

RESULTS

Immunoglobulin (Ig)A antibodies against tissue transglutaminase (IgA-TGA) were detected in all of the patients with CD and in 95% of the DH patients. The IgA-TGA and IgG-TGA levels were higher in group I (P < 0.001). The IgG-TGA levels and positivity rate in group I (100%) were higher than in group II (81%), group III (73%), and the DH group (67%). Elevated IgA-TGA and IgG-TGA levels in combination predicted a more severe small intestinal atrophy (P < 0.0001) with a specificity of 99% for Marsh IIIb-IIIc (flat) lesions. The kinetics of the IgA-TGA decrease during diet differed between groups I and II.

CONCLUSIONS

High levels of IgA-TGA and IgG-TGA antibodies were associated with the grade of mucosal villous atrophy and a more severe clinical presentation. The combined measurement of IgA-TGA and IgG-TGA enables a noninvasive prediction of small intestinal villous atrophy with high accuracy, and may reduce the need for a biopsy in patients with suspected CD.

Authors+Show Affiliations

Department of Women's and Children's Health/Paediatrics, Uppsala University, Uppsala, Sweden. ingrid.dahlbom@kbh.uu.seNo 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

19841593

Citation

Dahlbom, Ingrid, et al. "Prediction of Clinical and Mucosal Severity of Coeliac Disease and Dermatitis Herpetiformis By Quantification of IgA/IgG Serum Antibodies to Tissue Transglutaminase." Journal of Pediatric Gastroenterology and Nutrition, vol. 50, no. 2, 2010, pp. 140-6.
Dahlbom I, Korponay-Szabó IR, Kovács JB, et al. Prediction of clinical and mucosal severity of coeliac disease and dermatitis herpetiformis by quantification of IgA/IgG serum antibodies to tissue transglutaminase. J Pediatr Gastroenterol Nutr. 2010;50(2):140-6.
Dahlbom, I., Korponay-Szabó, I. R., Kovács, J. B., Szalai, Z., Mäki, M., & Hansson, T. (2010). Prediction of clinical and mucosal severity of coeliac disease and dermatitis herpetiformis by quantification of IgA/IgG serum antibodies to tissue transglutaminase. Journal of Pediatric Gastroenterology and Nutrition, 50(2), pp. 140-6. doi:10.1097/MPG.0b013e3181a81384.
Dahlbom I, et al. Prediction of Clinical and Mucosal Severity of Coeliac Disease and Dermatitis Herpetiformis By Quantification of IgA/IgG Serum Antibodies to Tissue Transglutaminase. J Pediatr Gastroenterol Nutr. 2010;50(2):140-6. PubMed PMID: 19841593.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prediction of clinical and mucosal severity of coeliac disease and dermatitis herpetiformis by quantification of IgA/IgG serum antibodies to tissue transglutaminase. AU - Dahlbom,Ingrid, AU - Korponay-Szabó,Ilma R, AU - Kovács,Judit B, AU - Szalai,Zsuzsanna, AU - Mäki,Markku, AU - Hansson,Tony, PY - 2009/10/21/entrez PY - 2009/10/21/pubmed PY - 2010/5/26/medline SP - 140 EP - 6 JF - Journal of pediatric gastroenterology and nutrition JO - J. Pediatr. Gastroenterol. Nutr. VL - 50 IS - 2 N2 - OBJECTIVES: We analysed whether the quantification of autoantibodies against tissue transglutaminase could be used to predict mucosal destruction and disease severity in patients with gluten sensitivity. PATIENTS AND METHODS: One hundred seventy patients with coeliac disease (CD), comprising 52 children with severe malabsorption (group I), 59 children with mild symptoms (group II), 59 adults (group III), 134 patients with dermatitis herpetiformis (DH), and 131 disease controls, were studied. Serial serum samples of patients in groups I and II on a gluten-free diet were also included. Serum levels of antibodies against recombinant tissue transglutaminase were determined with ELISA using standard curves for quantification of antibodies. RESULTS: Immunoglobulin (Ig)A antibodies against tissue transglutaminase (IgA-TGA) were detected in all of the patients with CD and in 95% of the DH patients. The IgA-TGA and IgG-TGA levels were higher in group I (P < 0.001). The IgG-TGA levels and positivity rate in group I (100%) were higher than in group II (81%), group III (73%), and the DH group (67%). Elevated IgA-TGA and IgG-TGA levels in combination predicted a more severe small intestinal atrophy (P < 0.0001) with a specificity of 99% for Marsh IIIb-IIIc (flat) lesions. The kinetics of the IgA-TGA decrease during diet differed between groups I and II. CONCLUSIONS: High levels of IgA-TGA and IgG-TGA antibodies were associated with the grade of mucosal villous atrophy and a more severe clinical presentation. The combined measurement of IgA-TGA and IgG-TGA enables a noninvasive prediction of small intestinal villous atrophy with high accuracy, and may reduce the need for a biopsy in patients with suspected CD. SN - 1536-4801 UR - https://www.unboundmedicine.com/medline/citation/19841593/Prediction_of_clinical_and_mucosal_severity_of_coeliac_disease_and_dermatitis_herpetiformis_by_quantification_of_IgA/IgG_serum_antibodies_to_tissue_transglutaminase_ L2 - http://Insights.ovid.com/pubmed?pmid=19841593 DB - PRIME DP - Unbound Medicine ER -