Sensitivity of Serum Tissue Transglutaminase Antibodies for Endomysial Antibody Positive and Negative Coeliac Disease

Dickey, William; McMillan, S A; Hughes, D.

doi:10.1080/003655201750153359

Cited by 55 publications

(25 citation statements)

References 14 publications

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“…The first aspect seems to be fully confirmed by recent reviews showing that serum IgA EmA antibodies have 90%-100% sensitivity and 95%-100% specificity and that IgA anti-tTG antibodies show very similar values (14,15 ), mainly obtained with the second-generation, human anti-tTG assays (9,16 ). However, the presence of positive serum antibodies has been shown to correlate with the degree of villous atrophy, and CD patients with less severe histologic damage can be seronegative for CD (17)(18)(19)(20). It has been demonstrated previously that the culture medium of intestinal biopsy specimens from some of these CD patients showed positive EmA antibodies, and this positivity can be useful for CD diagnosis in patients with minimal intestinal histologic lesions (8,21 ).…”

Section: Discussionmentioning

confidence: 79%

“…Histologic findings and the clinical follow-up confirmed that 162 of the 166 patients positive for serum EmA and/or anti-TG antibodies had CD. The other 4 patients (1 positive for EmA and anti-tTG antibodies, and 3 positive only for anti-tTG antibodies) in whom CD diagnosis was excluded showed a normal duodenal histology, with a villi/crypts ratio Ͼ3.5 and Ͻ30 IELs/100 epithelial cells (range, [12][13][14][15][16][17][18][19][20].…”

Section: Final Diagnoses In the Study Groupmentioning

confidence: 99%

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Anti-Transglutaminase Antibody Assay of the Culture Medium of Intestinal Biopsy Specimens Can Improve the Accuracy of Celiac Disease Diagnosis

Carroccio¹,

Prima²,

Pirrone³

et al. 2006

Clinical Chemistry

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Background:We measured anti-transglutaminase (antitTG) antibody in the culture medium of intestinal biopsy specimens from patients with suspected celiac disease (CD) and evaluated the relationship between antibody production and severity of intestinal mucosal damage. Methods: We performed diagnostic testing for CD on 273 consecutive patients. In addition to routine histologic evaluation of duodenal biopsy specimens, we assayed anti-tTG antibodies in serum and in the culture medium of duodenal biopsy specimens. Results: CD was diagnosed in 191 of the 273 patients. Sensitivity and specificity of the serum anti-endomysium (EmA) and anti-tTG assays were 83% and 85% and 99% and 95%, respectively, and both had 88% diagnostic accuracy. EmA and anti-tTG assayed in the culture medium had 98% sensitivity, 100% specificity, and 98% diagnostic accuracy (vs serum assays; P <0.0001). Twenty-nine CD patient specimens (16%) were negative for serum anti-tTG and EmA; for 24 of these patients, anti-tTG assay of the culture medium was positive. The CD patients whose biopsy specimens were positive for serum antibodies showed the following intestinal histologies: total villous atrophy, 35%; severe villous atrophy, 25%; mild atrophy, 25%; villi with no atrophy but with increased intraepithelial lymphocytes, 15%. None

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Section: Discussionmentioning

confidence: 79%

Section: Final Diagnoses In the Study Groupmentioning

confidence: 99%

Anti-Transglutaminase Antibody Assay of the Culture Medium of Intestinal Biopsy Specimens Can Improve the Accuracy of Celiac Disease Diagnosis

Carroccio¹,

Prima²,

Pirrone³

et al. 2006

Clinical Chemistry

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“…Antibodies to endomysium (IgA endomysium antibody, EMA) can be measured in serum via indirect immunofluoresence to provide a serological test for cluster of differentiation which has been shown to be highly sensitive and specific, with values for both parameters exceeding 95% in most studies (13). An alternative approach using an enzyme linked immunoabsorbent assay measuring IgA tissue transglutaminase antibody (tTGA) levels has comparable sensitivity and specificity, however, incomplete concordance between the two tests has led some authors to suggest combination screening (14). By contrast, the previously widely used antigliadin tests have been shown to have relatively poor sensitivity and specificity.…”

Section: Introductionmentioning

confidence: 99%

Serological screening for coeliac disease in adults with Turner's syndrome: prevalence and clinical significance of endomysium antibody positivity

Frost¹,

Band²,

Conway³

2009

European Journal of Endocrinology

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Objective: To investigate the prevalence of coeliac disease (CD) in an adult population with Turner's syndrome (TS). Design: A clinic population with TS was screened using a serological test for CD. Methods: Two hundred and fifty six patients with TS were included in the study. Five patients had existing diagnoses of CD. The remaining 251 asymptomatic patients were screened using an IgA endomysium antibody (EMA) test. Positive cases were offered endoscopy with duodenal biopsy. HLA typing was undertaken in existing cases and new EMA-positive cases. Results: Of the 251 patients screened, eight were found to be EMA positive (3.2%). Seven patients proceeded to duodenal biopsy on which all were confirmed histologically to have cluster of differentiation (2.8%). The prevalence of subclinical cluster of differentiation in the population can therefore be estimated between 2.8 and 3.2%. The total population prevalence of CD, including the previously diagnosed cases, is estimated between 4.7 and 5.1%. Ten patients with histologically confirmed cluster of differentiation underwent HLA typing of which eight were HLA-DQ2 positive, one was HLA-DQ8 positive and one was negative to both HLA-DQ2 and HLA-DQ8. Conclusions: This study demonstrates an increased prevalence of cluster of differentiation in an adult population with TS over the general population. This is consistent with previous data published in paediatric populations.

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“…5 It is well recognized that the combined use of the two antibodies (EMA and TTG) provides greater sensitivity in diagnosing celiac disease, since almost one third of the patients present reactivity for only one of the two antibodies. 23 However, from a practical standpoint, the sensitivity of commercial assays may vary and does not necessarily represent what is described in the literature, especially in subjects with major villous atrophy. An association between celiac disease and autoimmune thyroiditis has been reported worldwide, especially in Europe.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and clinical features of celiac disease in patients with autoimmune thyroiditis: cross-sectional study

et al. 2014

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CONTEXT AND OBJECTIVE: Celiac disease is an autoimmune disorder with an average prevalence of 1% in Europe and the United States. Because of strong European ancestry in southern Brazil, this study aimed to evaluate the seroprevalence of celiac disease among autoimmune thyroiditis patients. DESIGN AND SETTING: Cross-sectional study in a public university hospital. METHODS:This cross-sectional prevalence study included autoimmune thyroiditis patients who were tested for anti-endomysial and anti-transglutaminase antibodies between August 2010 and July 2011. RESULTS: Fifty-three patients with autoimmune thyroiditis were included; 92.5% were women, with mean age of 49.0 ± 13.5 years. Five patients (9.3%) were serologically positive for celiac disease: three of them (5.6%) were reactive for anti-endomysial antibodies and two (3.7%) for anti-transglutaminase. None of them exhibited anemia and one presented diarrhea. Endoscopy was performed on two patients: one with normal histology and the other with lymphocytic infiltrate and villous atrophy. CONCLUSION: The prevalence of celiac disease among patients with autoimmune thyroid disease was 9.3%; one patient complained of diarrhea and none presented anemia. Among at-risk populations, like autoimmune thyroiditis patients, the presence of diarrhea or anemia should not be used as a criterion for indicating celiac disease investigation. This must be done for all autoimmune thyroiditis patients because of its high prevalence. RESUMO CONTEXTO E OBJETIVO:A doença celíaca é uma doença autoimune, com prevalência média de 1% na Europa e nos Estados Unidos. Em função da forte ascendência europeia no sul do Brasil, este estudo objetiva relatar a soroprevalência de doença celíaca em indivíduos com tireoidite autoimune. TIPO DE ESTUDO E LOCAL: Estudo transversal em um hospital público universitário. MÉTODOS: Este estudo transversal de prevalência incluiu pacientes com tireoidite autoimune que foram submetidos a testes de anticorpos antiendomísio e antitransglutaminase entre agosto de 2010 e julho de 2011. RESULTADOS: Foram incluídos 53 pacientes com tireoidite autoimune, 92,5% mulheres, com idade média de 49,0 ± 13,5 anos. Cinco (9,3%) pacientes apresentaram sorologia positiva para doença celíaca, sendo três (5,6%) com anticorpo antiendomísio positivo e dois (3,7%) com antitransglutaminase positivo. Nenhum paciente apresentou anemia e um apresentou diarreia. Apenas dois pacientes realizaram endoscopia: um com histologia normal e outro apresentou infiltrado linfocitário e atrofia vilositária. CONCLUSÕES: A prevalência de doença celíaca entre pacientes com doença autoimune da tireoide foi de 9,3%; um paciente queixou-se de diarreia e ninguém apresentou anemia. Em populações de risco, como é o caso de pacientes com tireoidite autoimune, a presença de diarreia ou anemia não devem ser utilizados como critério para indicar investigação de doença celíaca, que deve ser feita em todos os indivíduos com tireoidite autoimune devido a sua alta prevalência.

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Sensitivity of Serum Tissue Transglutaminase Antibodies for Endomysial Antibody Positive and Negative Coeliac Disease

Cited by 55 publications

References 14 publications

Anti-Transglutaminase Antibody Assay of the Culture Medium of Intestinal Biopsy Specimens Can Improve the Accuracy of Celiac Disease Diagnosis

Anti-Transglutaminase Antibody Assay of the Culture Medium of Intestinal Biopsy Specimens Can Improve the Accuracy of Celiac Disease Diagnosis

Serological screening for coeliac disease in adults with Turner's syndrome: prevalence and clinical significance of endomysium antibody positivity

Prevalence and clinical features of celiac disease in patients with autoimmune thyroiditis: cross-sectional study

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