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IgG antibodies against deamidated gliadin peptides for diagnosis of celiac disease in patients with IgA deficiency.
Clin Chem. 2010 Mar; 56(3):464-8.CC

Abstract

BACKGROUND

Assays for IgG antibodies against deamidated gliadin (IgG-anti-dGli) are comparable in performance with tests detecting IgA antibodies against tissue transglutaminase (IgA-anti-tTG) in diagnosing celiac disease (CD). IgA-anti-tTG are absent in IgA deficiency, a condition often associated with CD. In IgA deficiency, IgG-anti-tTG, which have a lower overall diagnostic accuracy, are routinely measured. We examined whether IgG-anti-dGli would be useful for diagnosing CD in patients with IgA deficiency.

METHODS

We studied 34 IgA-deficient CD patients, 185 IgA-competent newly diagnosed children with CD, 316 children without CD, 400 adult blood donors, and 6 control IgA-deficient individuals without CD. Anti-dGli and anti-tTG were measured by ELISA, and endomysium antibodies (EmA) were measured by immunofluorescence on monkey esophagus (IgA as well as IgG class for all antibodies). We calculated diagnostic sensitivity (percentage of patients above cutoff with 95% CIs) according to age-specific cutoffs for 95% diagnostic specificity and according to cutoffs proposed by the manufacturer of the assays.

RESULTS

No IgA-deficient CD patients were positive for any IgA-based antibody assay. Diagnostic sensitivity of IgG-anti-tTG was 91.2% (95% CI 76.3%-97.7%) according to age-specific cutoffs and 82.4% (66.1%-92.0%) according to manufacturer cutoffs. The diagnostic sensitivity of IgG-EmA was 75.8% (58.8%-87.4%) and the sensitivity of IgG-anti-dGli was 88.2% (72.8%-95.9%) according to both cutoffs.

CONCLUSIONS

IgG-anti-dGli and IgG-anti-tTG have comparable diagnostic sensitivities for IgA-deficient celiac patients. IgG-anti-dGli may be useful for diagnosing CD in IgA-deficient patients.

Authors+Show Affiliations

Allergy and Immunology Unit, Azienda Ospedaliera San Maria degli Angeli, Pordenone, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo 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 Study
Journal Article

Language

eng

PubMed ID

20022984

Citation

Villalta, Danilo, et al. "IgG Antibodies Against Deamidated Gliadin Peptides for Diagnosis of Celiac Disease in Patients With IgA Deficiency." Clinical Chemistry, vol. 56, no. 3, 2010, pp. 464-8.
Villalta D, Tonutti E, Prause C, et al. IgG antibodies against deamidated gliadin peptides for diagnosis of celiac disease in patients with IgA deficiency. Clin Chem. 2010;56(3):464-8.
Villalta, D., Tonutti, E., Prause, C., Koletzko, S., Uhlig, H. H., Vermeersch, P., Bossuyt, X., Stern, M., Laass, M. W., Ellis, J. H., Ciclitira, P. J., Richter, T., Daehnrich, C., Schlumberger, W., & Mothes, T. (2010). IgG antibodies against deamidated gliadin peptides for diagnosis of celiac disease in patients with IgA deficiency. Clinical Chemistry, 56(3), 464-8. https://doi.org/10.1373/clinchem.2009.128132
Villalta D, et al. IgG Antibodies Against Deamidated Gliadin Peptides for Diagnosis of Celiac Disease in Patients With IgA Deficiency. Clin Chem. 2010;56(3):464-8. PubMed PMID: 20022984.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - IgG antibodies against deamidated gliadin peptides for diagnosis of celiac disease in patients with IgA deficiency. AU - Villalta,Danilo, AU - Tonutti,Elio, AU - Prause,Christian, AU - Koletzko,Sibylle, AU - Uhlig,H Holm, AU - Vermeersch,Pieter, AU - Bossuyt,Xavier, AU - Stern,Martin, AU - Laass,Martin W, AU - Ellis,Julia H, AU - Ciclitira,Paul J, AU - Richter,Thomas, AU - Daehnrich,Cornelia, AU - Schlumberger,Wolfgang, AU - Mothes,Thomas, Y1 - 2009/12/18/ PY - 2009/12/22/entrez PY - 2009/12/22/pubmed PY - 2010/4/2/medline SP - 464 EP - 8 JF - Clinical chemistry JO - Clin Chem VL - 56 IS - 3 N2 - BACKGROUND: Assays for IgG antibodies against deamidated gliadin (IgG-anti-dGli) are comparable in performance with tests detecting IgA antibodies against tissue transglutaminase (IgA-anti-tTG) in diagnosing celiac disease (CD). IgA-anti-tTG are absent in IgA deficiency, a condition often associated with CD. In IgA deficiency, IgG-anti-tTG, which have a lower overall diagnostic accuracy, are routinely measured. We examined whether IgG-anti-dGli would be useful for diagnosing CD in patients with IgA deficiency. METHODS: We studied 34 IgA-deficient CD patients, 185 IgA-competent newly diagnosed children with CD, 316 children without CD, 400 adult blood donors, and 6 control IgA-deficient individuals without CD. Anti-dGli and anti-tTG were measured by ELISA, and endomysium antibodies (EmA) were measured by immunofluorescence on monkey esophagus (IgA as well as IgG class for all antibodies). We calculated diagnostic sensitivity (percentage of patients above cutoff with 95% CIs) according to age-specific cutoffs for 95% diagnostic specificity and according to cutoffs proposed by the manufacturer of the assays. RESULTS: No IgA-deficient CD patients were positive for any IgA-based antibody assay. Diagnostic sensitivity of IgG-anti-tTG was 91.2% (95% CI 76.3%-97.7%) according to age-specific cutoffs and 82.4% (66.1%-92.0%) according to manufacturer cutoffs. The diagnostic sensitivity of IgG-EmA was 75.8% (58.8%-87.4%) and the sensitivity of IgG-anti-dGli was 88.2% (72.8%-95.9%) according to both cutoffs. CONCLUSIONS: IgG-anti-dGli and IgG-anti-tTG have comparable diagnostic sensitivities for IgA-deficient celiac patients. IgG-anti-dGli may be useful for diagnosing CD in IgA-deficient patients. SN - 1530-8561 UR - https://www.unboundmedicine.com/medline/citation/20022984/full_citation L2 - https://academic.oup.com/clinchem/article-lookup/doi/10.1373/clinchem.2009.128132 DB - PRIME DP - Unbound Medicine ER -