Sensitivity of Antiendomysium and Antigliadin Antibodies in Untreated Celiac Disease: Disappointing in Clinical Practice

Rostami, Kamran; Kerckhaert, J.; Tiemessen, R.; Blomberg, Maureen; Meijer, Jos W. R.; Mulder, Chris J.

doi:10.1111/j.1572-0241.1999.983_f.x

Cited by 421 publications

(107 citation statements)

References 26 publications

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“…Histopathology was expressed according to the Marsh modified classification [13,14]. For the cutoff for intraepithelial lymphocytes, we used 25/100 according to Hayat et al [15] and Dickson et al [16].…”

Section: Histological Classificationmentioning

confidence: 99%

Complications in Celiac Disease Under Gluten-Free Diet

et al. 2008

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We assessed the onset of malignant and nonmalignant complications in a cohort of celiac disease (CD) patients under gluten-free diet (GFD). Five hundred and forty-nine CD patients were retrospectively assessed. Two hundred and fifty-one (45.7%) showed classical, 262 (47.7%) subclinical, and 36 (6.6%) silent form of CD at the time of the diagnosis. The mean time under GFD was 7.13 years (range 1-15 years). Out of 549 patients, 381 (69.4%) were fully compliant, 112/549 (20.4%) reported less than one dietary transgression/month, and 56/549 (10.2%) reported at least one dietary transgression/month. Out of 549 patients, 18 (3.3%) patients developed complications under GFD (seven malignant and 11 nonmalignant complications). Fourteen patients were previously affected by classical CD (5.6% of the overall patients with classical CD), and four were affected by subclinical CD (1.5% of the overall patients with subclinical CD). None of the patients affected by silent CD developed complications. There was no statistical difference between the mean age of the two groups developing complications (P = n.s.). Complications appeared after a mean time under GFD of 6.5 years in classical CD, and after a mean time of 3.5 years in subclinical CD (P = n.s.). Finally, 6/14 (42.8%) patients with classical CD were not fully compliant to GFD, while 2/4 (50%) of subclinical CD patients were not fully compliant to GFD (P = n.s.). Less than 5% of CD patients may develop complications under GFD. Complications seem to affect more classical CD than subclinical CD, and seem to be irrespective of optimal GFD adherence.

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Section: Histological Classificationmentioning

confidence: 99%

Complications in Celiac Disease Under Gluten-Free Diet

et al. 2008

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“…These antibodies may be present in inflammatory bowel disease [97], collagen vascular disease [98] and in many healthy people [99]. However, combining AGAs, with other serologic tests increases the sensitivity of the serologic tests [100], thus increasing the overall detection rate of CD.…”

Section: Diagnosis Of CDmentioning

confidence: 99%

Mechanisms underlying celiac disease and its neurologic manifestations

Green

Alaedini

Sander

et al. 2005

CMLS, Cell. Mol. Life Sci.

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The extra-intestinal manifestations of celiac disease (CD), including ataxia and peripheral neuropathy, are increasingly being recognized as the presenting symptoms of this autoimmune disease. Although there is a greater understanding of the pathogenesis of the intestinal lesions in CD the mechanisms behind the neurologic manifestations of CD have not been elucidated. In this article, the authors review the cellular and molecular mechanisms behind the histopathologic changes in the intestine, discuss the presentation and characteristics of neurologic manifestations of CD, review the data on the mechanisms behind these manifestations, and discuss the diagnosis and treatment of CD. Molecular mimicry and intermolecular help may play a role in the development of neurologic complications.

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“…The finding that most IgA-EmA and anti-tTG IgA-negative patients were under 2 years of age is in agreement with previous reports [9, 38, 39], and could explain the relatively low frequency of these antibodies in this study. Some recent studies have questioned the high sensitivity of IgA-EmA for the whole spectrum of CoD [40, 41], and it has been shown that IgA-EmA testing fails to identify one fifth of patients, even among those with subtotal villous atrophy [41]. In this regard the significance of anti-cytoskeletal IgA antibodies as supplementary serologic markers for CoD should be further studied, as well as their association with the degree of intestinal tissue rearrangements in CoD.…”

Section: Discussionmentioning

confidence: 99%

Increased Levels of IgA Antibodies against Desmin in Children with Coeliac Disease

Teesalu¹,

Uibo

Kalkkinen

et al. 2001

Int Arch Allergy Immunol

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Background: In addition to IgA anti-endomysial antibodies, IgA anti-smooth muscle antibodies have been observed in a number of patients with coeliac disease (CoD), but only limited data exist on the frequency and antigen specificity of IgA against cytoskeletal proteins in CoD. Methods: We evaluated the sera of 42 untreated CoD patients, follow-up sera of 26 CoD patients after treatment, and 116 control sera for IgA reactivity to cytoskeletal proteins from the human umbilical cord (HUC) by immunoblotting, and compared the results with anti-tissue transglutaminase IgA (anti-tTG IgA) ELISA and immunofluorescence results. Results: Serum IgA from CoD patients most frequently recognized a 57-kD antigen in HUC cytoskeletal extract, identified as desmin using mass spectrometry and internal peptide sequencing. Increased IgA reactivity to the human desmin band was detected in 22 children with untreated CoD (52.4%), in 4 treated CoD patients (15.4%), and in 12 control subjects (10.3%) (p < 0.01); similar results were obtained with anti-chicken desmin IgA ELISA. Anti-tTG IgA levels (increased in 71.4% of untreated CoD patients) correlated significantly with anti-desmin IgA levels in untreated CoD, and both autoantibody reactivities decreased in response to a gluten-free diet. Pre-adsorption experiments and affinity purification of anti-desmin IgA antibodies further confirmed that desmin is an IgA autoantigen in CoD and is recognized by antibodies which are not cross-reactive with tTG. Conclusions: Anti-desmin IgA antibodies are frequently occurring if not the predominant cytoskeletal antibodies in children with untreated CoD and could be related to the disease process in the small intestine.

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Sensitivity of Antiendomysium and Antigliadin Antibodies in Untreated Celiac Disease: Disappointing in Clinical Practice

Cited by 421 publications

References 26 publications

Complications in Celiac Disease Under Gluten-Free Diet

Complications in Celiac Disease Under Gluten-Free Diet

Mechanisms underlying celiac disease and its neurologic manifestations

Increased Levels of IgA Antibodies against Desmin in Children with Coeliac Disease

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