Simultaneous detection of IgA and IgG antibodies against tissue transglutaminase: The preferred pre-biopsy test in childhood celiac disease

Objectives IgA antibodies against tissue transglutaminase (anti-TG2) is a reliable marker of celiac disease (CD). However, IgA-deficient patients are not identified and young children may lack IgA anti-TG2. Combined detection of IgA and IgG (IgA/IgG) against deamidated gliadin peptides (DGP) has sho...

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Bibliographic Details
Published in:Scandinavian journal of clinical and laboratory investigation 2016-04, Vol.76 (3), p.208-216
Main Authors: Dahlbom, Ingrid, Nyberg, Britt-Inger, Berntson, Lillemor, Hansson, Tony
Format: Article
Language:English
Subjects:
Adolescent
autoantibodies
Autoantibodies - blood
Biopsy
Celiac disease
Celiac Disease - blood
Celiac Disease - diagnosis
Child
Child, Preschool
children
Female
gliadin
GTP-Binding Proteins - immunology
Humans
Immunoglobulin A - blood
Immunoglobulin G - blood
Infant
Male
ROC Curve
tissue transglutaminase
Transglutaminases - immunology
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Summary:Objectives IgA antibodies against tissue transglutaminase (anti-TG2) is a reliable marker of celiac disease (CD). However, IgA-deficient patients are not identified and young children may lack IgA anti-TG2. Combined detection of IgA and IgG (IgA/IgG) against deamidated gliadin peptides (DGP) has shown a high diagnostic performance for untreated CD. Here we examined the utility of IgA/IgG anti-TG2, IgA/IgG anti-DGP and IgA/IgG against a mix of TG2 and DGP (anti-TG2/DGP) in finding CD among children. Methods Serum antibodies against TG2, DGP, and TG2/DGP were determined with ELISA in 242 children referred to a paediatric gastroenterologist. Fifty had untreated CD verified by an intestinal biopsy and 192/242 children had other diseases than CD. Results Forty-eight untreated CD children had increased IgA/IgG anti-TG2, 47/50 had increased IgA/IgG anti-DGP and 46/50 had increased IgA/IgG anti-TG2/DGP. One control subject had increased IgA/IgG anti-TG2 and IgA/IgG anti-TG2/DGP, whereas 7/192 control subjects had increased IgA/IgG anti-DGP. The IgA/IgG anti-TG2 assay had the best performance with a sensitivity of 96%, a specificity of 99.5% and the area under the ROC-curve was 0.996 (95% CI 0.992-1, p 
ISSN:0036-5513
1502-7686
1502-7686
DOI:10.3109/00365513.2015.1137348