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Specific celiac disease antibodies in children on a gluten-free diet.
Pediatrics. 2011 Sep; 128(3):547-52.Ped

Abstract

OBJECTIVE

Celiac disease (CD) is characterized by histologic alterations in small bowel biopsies. Circulating specific CD antibodies at the time of diagnosis and their disappearance after a gluten-free diet support the diagnosis of CD. We aimed to determine the behavior of the CD antibodies immunoglobulin A anti-tissue transglutaminase (anti-TG2) and immunoglobulin A endomysium (EMA) in children with CD after starting a gluten-free diet.

METHODS

This was a retrospective multicenter study in the Netherlands between 2001 and 2009. Inclusion criteria were all newly diagnosed patients with CD younger than 19 years who had at least 1 anti-TG2 and/or EMA measurement before and after starting a gluten-free diet. Eight different anti-TG2 kits were used with substrates of guinea pig TG2 in 1 (Sigma) and 7 human-recombinant TG2: Varelisa and EliA Celikey Phadia-GmbH; Orgentec Diagnostica-GmbH; Diarect AG; Roboscreen GmbH; Aeskulisa Diagnostics; Binding Site Ltd. EMA was analyzed with indirect immunofluorescence tests. Statistical analyses were performed by using mixed-model repeated measurements and survival analysis.

RESULTS

There were 129 children with CD included (mean age: 5.6 years; SD ± 4.2). The mean concentration of anti-TG2 decreased significantly within 3 months after starting a gluten-free diet (P < .0001). The cumulative percentage of children who became negative for EMA after ½, 1, 1½, and 2 years was 31%, 60%, 74%, and 87%, respectively. For anti-TG2, a comparable trend was shown: 35%, 55%, 64%, and 78%, respectively.

CONCLUSIONS

Doctors taking care of children with CD should be aware that the mean concentration of anti-TG2 will show a 74% decrease (95% confidence interval: 69%-79%) after 3 months of gluten-free diet, and ∼80% of the children will be sero-negative for EMA and anti-TG2 after 2 years of the diet.

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Publisher Full Text

Authors+Show Affiliations

Hogen Esch CE
Department of Pediatric Gastroenterology, Leiden University Medical Centre, Leiden, Netherlands. c.e.hogen_esch@lumc.nl
Wolters VM
No affiliation info available
Gerritsen SA
No affiliation info available
Putter H
No affiliation info available
von Blomberg BM
No affiliation info available
van Hoogstraten IM
No affiliation info available
Houwen RH
No affiliation info available
van der Lely N
No affiliation info available
Mearin ML
No affiliation info available

MeSH

Antibodies, Anti-IdiotypicAutoantibodiesCeliac DiseaseChildChild, PreschoolDiet, Gluten-FreeFemaleFluorescent Antibody Technique, IndirectGTP-Binding ProteinsHumansImmunoglobulin AInfantIntestinal MucosaMaleRetrospective StudiesTransglutaminases

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

21859913

Citation

Hogen Esch, Caroline E., et al. "Specific Celiac Disease Antibodies in Children On a Gluten-free Diet." Pediatrics, vol. 128, no. 3, 2011, pp. 547-52.
Hogen Esch CE, Wolters VM, Gerritsen SA, et al. Specific celiac disease antibodies in children on a gluten-free diet. Pediatrics. 2011;128(3):547-52.
Hogen Esch, C. E., Wolters, V. M., Gerritsen, S. A., Putter, H., von Blomberg, B. M., van Hoogstraten, I. M., Houwen, R. H., van der Lely, N., & Mearin, M. L. (2011). Specific celiac disease antibodies in children on a gluten-free diet. Pediatrics, 128(3), 547-52. https://doi.org/10.1542/peds.2010-3762
Hogen Esch CE, et al. Specific Celiac Disease Antibodies in Children On a Gluten-free Diet. Pediatrics. 2011;128(3):547-52. PubMed PMID: 21859913.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Specific celiac disease antibodies in children on a gluten-free diet. AU - Hogen Esch,Caroline E, AU - Wolters,Victorien M, AU - Gerritsen,Susan A M, AU - Putter,Hein, AU - von Blomberg,B Mary, AU - van Hoogstraten,Ingrid M W, AU - Houwen,Roderick H J, AU - van der Lely,Nico, AU - Mearin,M Luisa, Y1 - 2011/08/22/ PY - 2011/8/24/entrez PY - 2011/8/24/pubmed PY - 2012/4/24/medline SP - 547 EP - 52 JF - Pediatrics JO - Pediatrics VL - 128 IS - 3 N2 - OBJECTIVE: Celiac disease (CD) is characterized by histologic alterations in small bowel biopsies. Circulating specific CD antibodies at the time of diagnosis and their disappearance after a gluten-free diet support the diagnosis of CD. We aimed to determine the behavior of the CD antibodies immunoglobulin A anti-tissue transglutaminase (anti-TG2) and immunoglobulin A endomysium (EMA) in children with CD after starting a gluten-free diet. METHODS: This was a retrospective multicenter study in the Netherlands between 2001 and 2009. Inclusion criteria were all newly diagnosed patients with CD younger than 19 years who had at least 1 anti-TG2 and/or EMA measurement before and after starting a gluten-free diet. Eight different anti-TG2 kits were used with substrates of guinea pig TG2 in 1 (Sigma) and 7 human-recombinant TG2: Varelisa and EliA Celikey Phadia-GmbH; Orgentec Diagnostica-GmbH; Diarect AG; Roboscreen GmbH; Aeskulisa Diagnostics; Binding Site Ltd. EMA was analyzed with indirect immunofluorescence tests. Statistical analyses were performed by using mixed-model repeated measurements and survival analysis. RESULTS: There were 129 children with CD included (mean age: 5.6 years; SD ± 4.2). The mean concentration of anti-TG2 decreased significantly within 3 months after starting a gluten-free diet (P < .0001). The cumulative percentage of children who became negative for EMA after ½, 1, 1½, and 2 years was 31%, 60%, 74%, and 87%, respectively. For anti-TG2, a comparable trend was shown: 35%, 55%, 64%, and 78%, respectively. CONCLUSIONS: Doctors taking care of children with CD should be aware that the mean concentration of anti-TG2 will show a 74% decrease (95% confidence interval: 69%-79%) after 3 months of gluten-free diet, and ∼80% of the children will be sero-negative for EMA and anti-TG2 after 2 years of the diet. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/21859913/Specific_celiac_disease_antibodies_in_children_on_a_gluten_free_diet_ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&amp;pmid=21859913 DB - PRIME DP - Unbound Medicine ER -