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Isolated positive anti-gliadin immunoglobin-A antibody in children with gastrointestinal symptoms.
Turk J Gastroenterol 2012; 23(5):485-9TJ

Abstract

BACKGROUND/AIMS

The use of immunoglobulin G and A anti-gliadin antibodies for celiac disease screening has decreased due to higher specificity and sensitivity of tissue transglutaminase and endomysial antibodies. Greater values of immunoglobulin-A anti-gliadin antibody have been associated with more severe mucosal damage in proven and probable celiac disease patients. The aim of this study was to determine whether anti-gliadin antibody immunoglobulin A has any clinical importance in diagnosing celiac disease in children. Children with a chronic history of vomiting, abdominal pain, diarrhea, or constipation in the outpatient clinic were evaluated for celiac disease.

MATERIALS AND METHODS

Tissue transglutaminase and anti-gliadin antibody immunoglobulin A in serum were determined by ELISA test and endomysial antibodies immunoglobulin A by indirect immunofluorescence. Most of these children with isolated positive anti-gliadin antibody immunoglobulin A were further evaluated by performing proximal gastrointestinal biopsies.

RESULTS

Sixteen children had isolated positive anti-gliadin antibody immunoglobulin A (negative tissue transglutaminase and endomysial antibodies immunoglobulin A). Eight were male (mean age: 9.7 years). None had immunoglobulin A deficiency. Thirteen underwent an upper endoscopy with multiple small bowel biopsies. Two patients had villous atrophy and slightly increased intraepithelial lymphocytes (Marsh 3a), which could make the diagnosis of celiac disease likely. These two patients had high titers of anti-gliadin antibody immunoglobulin A above 70 Units.

CONCLUSIONS

An isolated positive antigliadin antibody immunoglobulin A result in the absence of positive tissue transglutaminase and endomysial antibodies immunoglobulin A should raise the suspicion of the diagnosis of celiac disease. This could be a non-specific phenomenon that could be found in other gastrointestinal conditions, latent celiac disease, or gluten hypersensitivity. A longitudinal clinical follow-up is recommended in these children to confirm the diagnosis.

Authors+Show Affiliations

Johns Hopkins University School of Medicine, Pediatrics, Baltimore, USA. wkarnsa1@jhmi.edu.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

23161323

Citation

Karnsakul, Wikrom, et al. "Isolated Positive Anti-gliadin immunoglobin-A Antibody in Children With Gastrointestinal Symptoms." The Turkish Journal of Gastroenterology : the Official Journal of Turkish Society of Gastroenterology, vol. 23, no. 5, 2012, pp. 485-9.
Karnsakul W, Skitarelic K, Gillespie S, et al. Isolated positive anti-gliadin immunoglobin-A antibody in children with gastrointestinal symptoms. Turk J Gastroenterol. 2012;23(5):485-9.
Karnsakul, W., Skitarelic, K., Gillespie, S., & Arkachaisri, T. (2012). Isolated positive anti-gliadin immunoglobin-A antibody in children with gastrointestinal symptoms. The Turkish Journal of Gastroenterology : the Official Journal of Turkish Society of Gastroenterology, 23(5), pp. 485-9.
Karnsakul W, et al. Isolated Positive Anti-gliadin immunoglobin-A Antibody in Children With Gastrointestinal Symptoms. Turk J Gastroenterol. 2012;23(5):485-9. PubMed PMID: 23161323.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Isolated positive anti-gliadin immunoglobin-A antibody in children with gastrointestinal symptoms. AU - Karnsakul,Wikrom, AU - Skitarelic,Kathryn, AU - Gillespie,Stacey, AU - Arkachaisri,Thaschawee, PY - 2012/11/20/entrez PY - 2012/11/20/pubmed PY - 2013/5/10/medline SP - 485 EP - 9 JF - The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology JO - Turk J Gastroenterol VL - 23 IS - 5 N2 - BACKGROUND/AIMS: The use of immunoglobulin G and A anti-gliadin antibodies for celiac disease screening has decreased due to higher specificity and sensitivity of tissue transglutaminase and endomysial antibodies. Greater values of immunoglobulin-A anti-gliadin antibody have been associated with more severe mucosal damage in proven and probable celiac disease patients. The aim of this study was to determine whether anti-gliadin antibody immunoglobulin A has any clinical importance in diagnosing celiac disease in children. Children with a chronic history of vomiting, abdominal pain, diarrhea, or constipation in the outpatient clinic were evaluated for celiac disease. MATERIALS AND METHODS: Tissue transglutaminase and anti-gliadin antibody immunoglobulin A in serum were determined by ELISA test and endomysial antibodies immunoglobulin A by indirect immunofluorescence. Most of these children with isolated positive anti-gliadin antibody immunoglobulin A were further evaluated by performing proximal gastrointestinal biopsies. RESULTS: Sixteen children had isolated positive anti-gliadin antibody immunoglobulin A (negative tissue transglutaminase and endomysial antibodies immunoglobulin A). Eight were male (mean age: 9.7 years). None had immunoglobulin A deficiency. Thirteen underwent an upper endoscopy with multiple small bowel biopsies. Two patients had villous atrophy and slightly increased intraepithelial lymphocytes (Marsh 3a), which could make the diagnosis of celiac disease likely. These two patients had high titers of anti-gliadin antibody immunoglobulin A above 70 Units. CONCLUSIONS: An isolated positive antigliadin antibody immunoglobulin A result in the absence of positive tissue transglutaminase and endomysial antibodies immunoglobulin A should raise the suspicion of the diagnosis of celiac disease. This could be a non-specific phenomenon that could be found in other gastrointestinal conditions, latent celiac disease, or gluten hypersensitivity. A longitudinal clinical follow-up is recommended in these children to confirm the diagnosis. SN - 2148-5607 UR - https://www.unboundmedicine.com/medline/citation/23161323/Isolated_positive_anti_gliadin_immunoglobin_A_antibody_in_children_with_gastrointestinal_symptoms_ L2 - http://www.turkjgastroenterol.org/eng/makale/2892/207/Full-Text DB - PRIME DP - Unbound Medicine ER -