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Antiendomysium antibodies assay in the culture medium of intestinal mucosa: an accurate method for celiac disease diagnosis.
Eur J Gastroenterol Hepatol 2011; 23(11):1018-23EJ

Abstract

BACKGROUND

Celiac disease (CD) diagnosis is becoming more difficult as patients with no intestinal histology lesions may also be suffering from CD.

AIM

To evaluate the diagnostic accuracy of antiendomysium (EmA) assay in the culture medium of intestinal biopsies for CD diagnosis.

PATIENTS AND METHODS

The clinical charts of 418 patients with CD and 705 non-CD controls who had all undergone EmA assay in the culture medium were reviewed.

RESULTS

EmA assay in the culture medium had a higher sensitivity (98 vs. 80%) and specificity (99 vs. 95%) than serum EmA/antibodies to tissue transglutaminase (anti-tTG) assay. All patients with CD who were tested as false-negatives for serum EmA and/or anti-tTG (32 adults and 39 children) carried the human leukocyte antigen alleles associated to CD. Furthermore, during the follow-up, four patients with negative-serum EmA/anti-tTG, normal villi architecture, and positive-EmAs in the culture medium, developed villous atrophy and underwent gluten-free diet with consequent resolution of the symptoms and complete intestinal histology recovery.

CONCLUSION

EmA assay in the culture medium should be included in the diagnostic criteria for CD diagnosis in 'seronegative' patients.

Authors+Show Affiliations

Department of Internal Medicine, Ospedali Civili Riuniti, Sciacca AG, Italy. acarroccio@hotmail.cNo 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 availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

21885984

Citation

Carroccio, Antonio, et al. "Antiendomysium Antibodies Assay in the Culture Medium of Intestinal Mucosa: an Accurate Method for Celiac Disease Diagnosis." European Journal of Gastroenterology & Hepatology, vol. 23, no. 11, 2011, pp. 1018-23.
Carroccio A, Iacono G, Di Prima L, et al. Antiendomysium antibodies assay in the culture medium of intestinal mucosa: an accurate method for celiac disease diagnosis. Eur J Gastroenterol Hepatol. 2011;23(11):1018-23.
Carroccio, A., Iacono, G., Di Prima, L., Pirrone, G., Cavataio, F., Ambrosiano, G., ... Di Fede, G. (2011). Antiendomysium antibodies assay in the culture medium of intestinal mucosa: an accurate method for celiac disease diagnosis. European Journal of Gastroenterology & Hepatology, 23(11), pp. 1018-23. doi:10.1097/MEG.0b013e328349b8a5.
Carroccio A, et al. Antiendomysium Antibodies Assay in the Culture Medium of Intestinal Mucosa: an Accurate Method for Celiac Disease Diagnosis. Eur J Gastroenterol Hepatol. 2011;23(11):1018-23. PubMed PMID: 21885984.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antiendomysium antibodies assay in the culture medium of intestinal mucosa: an accurate method for celiac disease diagnosis. AU - Carroccio,Antonio, AU - Iacono,Giuseppe, AU - Di Prima,Lidia, AU - Pirrone,Giuseppe, AU - Cavataio,Francesca, AU - Ambrosiano,Giuseppe, AU - Sciumè,Carmelo, AU - Geraci,Girolamo, AU - Florena,Ada, AU - Teresi,Saverio, AU - Barbaria,Franco, AU - Pepe,Ilenia, AU - Campisi,Giuseppina, AU - Mansueto,Pasquale, AU - Soresi,Maurizio, AU - Di Fede,Gaetana, PY - 2011/9/3/entrez PY - 2011/9/3/pubmed PY - 2012/2/1/medline SP - 1018 EP - 23 JF - European journal of gastroenterology & hepatology JO - Eur J Gastroenterol Hepatol VL - 23 IS - 11 N2 - BACKGROUND: Celiac disease (CD) diagnosis is becoming more difficult as patients with no intestinal histology lesions may also be suffering from CD. AIM: To evaluate the diagnostic accuracy of antiendomysium (EmA) assay in the culture medium of intestinal biopsies for CD diagnosis. PATIENTS AND METHODS: The clinical charts of 418 patients with CD and 705 non-CD controls who had all undergone EmA assay in the culture medium were reviewed. RESULTS: EmA assay in the culture medium had a higher sensitivity (98 vs. 80%) and specificity (99 vs. 95%) than serum EmA/antibodies to tissue transglutaminase (anti-tTG) assay. All patients with CD who were tested as false-negatives for serum EmA and/or anti-tTG (32 adults and 39 children) carried the human leukocyte antigen alleles associated to CD. Furthermore, during the follow-up, four patients with negative-serum EmA/anti-tTG, normal villi architecture, and positive-EmAs in the culture medium, developed villous atrophy and underwent gluten-free diet with consequent resolution of the symptoms and complete intestinal histology recovery. CONCLUSION: EmA assay in the culture medium should be included in the diagnostic criteria for CD diagnosis in 'seronegative' patients. SN - 1473-5687 UR - https://www.unboundmedicine.com/medline/citation/21885984/Antiendomysium_antibodies_assay_in_the_culture_medium_of_intestinal_mucosa:_an_accurate_method_for_celiac_disease_diagnosis_ L2 - http://Insights.ovid.com/pubmed?pmid=21885984 DB - PRIME DP - Unbound Medicine ER -