Anti-endomysial antibody negative celiac disease: Does additional serological testing help?

Anti-endomysium antibodies (AEM) fail to identify all untreated celiac disease (CD) patients. This study aims to determine if additional serology, in particular, IgA anti-tissue transglutaminase (tTG) antibodies, increases detection. Fifty-three biopsy-proven untreated CD patients (39 women, 14 men;...

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Bibliographic Details
Published in:Digestive diseases and sciences 2001, Vol.46 (1), p.214-221
Main Authors: DAHELE, Anna, KINGSTONE, Kathleen, BODE, John, ANDERSON, Diane, GHOSH, Subrata
Format: Article
Language:English
Subjects:
Adult
Aged
Antibodies - blood
Biological and medical sciences
Celiac disease
Celiac Disease - diagnosis
Female
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Immunoglobulin A - blood
Liver. Biliary tract. Portal circulation. Exocrine pancreas
Male
Medical sciences
Middle Aged
Muscle Fibers, Skeletal - immunology
Other diseases. Semiology
Prospective Studies
Reticulin - immunology
Serologic Tests
Transglutaminases - immunology
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Summary:Anti-endomysium antibodies (AEM) fail to identify all untreated celiac disease (CD) patients. This study aims to determine if additional serology, in particular, IgA anti-tissue transglutaminase (tTG) antibodies, increases detection. Fifty-three biopsy-proven untreated CD patients (39 women, 14 men; median age 51 years) and 65 control patients with normal duodenal histology (46 women, 19 men; age range 17-90 years, median 45 years) were prospectively studied. Serum total IgA, IgA anti-tTG, IgA AEM, IgA anti-gliadin (AGA) and IgG AGA antibodies were measured. Thirteen (25%) CD patients were AEM negative. None were IgA deficient. Three AEM-negative CD patients had a raised IgA anti-tTG and IgA AGA. IgG AGA was raised in 10 AEM-negative CD patients, but also in 14/65 (22%) of controls. In conclusion, AEM-negative CD is common and detection is only modestly enhanced by testing for IgA anti-tTG antibodies. Duodenal biopsy is still recommended for the accurate diagnosis of CD.
ISSN:0163-2116
1573-2568
DOI:10.1023/A:1005589202529