Testing for Antireticulin Antibodies in Patients with Celiac Disease Is Obsolete: a Review of Recommendations for Serologic Screening and the Literature

Nandiwada, Sarada L.; Tebo, Anne E.

doi:10.1128/cvi.00568-12

Cited by 13 publications

(12 citation statements)

References 44 publications

(69 reference statements)

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“…Antibodies such as IgA anti‐tissue transglutaminase (anti‐tTG), anti‐endomysium (anti‐EMA), IgA and IgG GLA are considered the primary tools for screening candidates for duodenal biopsy and confirmation of CD diagnosis 86 . Other serological tests used for CD evaluation such as antireticulin antibodies have shown poor sensitivity and are no longer used in clinical practice 87 …”

Section: Discussionmentioning

confidence: 99%

Prevalence of latent and overt polyautoimmunity in autoimmune thyroid disease: A systematic review and meta‐analysis

Botello

Herrán

Salcedo

et al. 2020

Clinical Endocrinology

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Background Thyroid autoimmunity is the most frequent condition involved in polyautoimmunity (PolyA). However, the frequency of latent and overt PolyA in patients with autoimmune thyroid disease (AITD) as the index condition is unknown. Therefore, the purpose of this study was to determine the prevalence of these types of PolyA in patients with AITD as the index condition. Methods This study adhered to the relevant sections of the Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA) guideline. Searches through MEDLINE, Embase and LILACS were done to find articles in Spanish and English. Relevant vocabulary terms and key terms related to AITD and other autoimmune diseases were used. Two investigators independently screened the eligible studies, extracted data and assessed the quality and risk of bias. Fixed and random effect models were used accordingly. Cluster analysis was used to determine similarities among diseases in the articles included (based on Jaccard index). Results A total of 56 articles fulfilled the inclusion criteria. Of these, 25 were case‐controls, 17 were cohorts, and 14 were cross‐sectional studies. These studies included a total of 47 509 patients. Female was the predominant gender and included 38 950 patients (81.23%, 95% CI: 80.85‐81.60). Graves’ disease (GD) was the most common type of thyroid autoimmunity (69.16%, 95% CI: 68.23‐70.07). Globally, overt PolyA was found in 13.46% of the patients with AITD. This type of PolyA was represented mainly by type 1 diabetes and autoimmune gastritis. Latent PolyA was presented in 17.45% of the patients, and anti‐proinsulin, anti‐parietal cells and dsDNA antibodies were the most common. HT had the highest frequency of overt PolyA in Europe (15.60%, 95% CI: 14.72‐16.53), whereas latent PolyA was most common in patients with GD in Asia (21.03%, 95% CI: 17.76‐24.71). Overt and latent PolyA were associated with gastrointestinal and endocrinological ADs in most of cases and clustered with rheumatological, dermatological and neurological ADs. Conclusions Latent and overt PolyA are common in patients with AITD. These results provide insightful information for early diagnosis and management of concurrent ADs in patients with AITD. Aggregation of ADs in different clusters may help to define different phenotypes associated with thyroid autoimmunity that are critically relevant in clinical settings.

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Section: Discussionmentioning

confidence: 99%

Prevalence of latent and overt polyautoimmunity in autoimmune thyroid disease: A systematic review and meta‐analysis

Botello

Herrán

Salcedo

et al. 2020

Clinical Endocrinology

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“…Both EMA anti-R1 reticulin reactivities seen in CD arise due to an immune response to TG2 [42]. Many studies described ARA in sera of the CD patients [43] but ARA have lack optimal sensitivities and specificities in CD [44].  G. Samasca et al…”

Section: Serological Testsmentioning

confidence: 93%

Immunological Approach of the Challenges of the XXI Century in Celiac Disease

Samaşcă

Lupan

Deleanu

et al. 2013

International Reviews of Immunology

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“…The detection of ARA, as described by Calvani et al [54], even though useful in basic screening, is much less specific than that of AEmA. Nevertheless, the presence of both, AEmA and ARA together, predicts the diagnosis of CD with a high probability [55,56]. When using the endomysium/gliadin diagnostic mosaic kit (Euroimmun) consisting of sections of primate liver, rat oesophagus and/or small intestine along with the gliadin coated microdots (taking advantage of a pure and specific gliadin antigen), the parallel detection of antibodies to gliadin along with AEmA and ARA is of great diagnostic value [57].…”

Section: Celiac Disease Versus Inflammatory Bowel Disease: Serologicamentioning

confidence: 99%

The Malabsorption Syndrome versus Celiac Disease: A Diagnostic Reappraisal

Beseda¹,

Bencat²,

Korinkova³

et al. 2016

IJCD

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The most frequent cause of malabsorption syndrome (MAS) in developed countries is the celiac disease (CD). There are two possible approaches for exact diagnostic of this disorder: in case of full blown clinical symptoms the golden standard is duodenal biopsy. When it shows classical mucosa lesions (Marsh type 3 mucosa atrophy of various grades), the diagnosis of CD is confirmed. However, if intraepithelial lymphocyte infiltration (IEL) and/or hyperplastic crypts can be seen in the absence of mucosa atrophy (Marsh type 1 and/or 2 lesions) only, it is reasonable to examine the serologic markers. The most frequent enzyme linked immunosorbent assay (ELISA) tests are: detection of tissue transglutaminase 2 antibody (anti-tTGase 2, especially of IgA class) and the deamidated gliadin peptide antibody (anti-DGP) assay. A simpler serological test, useful for screening, is the detection of antiendomysium antibody (AEmA) by indirect fluorescent antibody (IFA) in monkey intestine or esophagus sections. This is reasonable to combine with the microdot test for anti-gliadin antibody (AGA), especially by using the endomysium/gliadin mosaic kit (Euroimmun). Taken together, at least three serological markers (anti-tTGase 2, anti-DGP and AGA) are highly specific for CD; their detection first (i.e. prior to duodenal biopsy) is recommended in children as well as in adults showing atypical, silent and or latent forms of CD. In both of them, serology represents a reliable non-invasive approach, which allows precise diagnosis with a probability of nearly 90 %. Another advantage of the non-invasive serological technic is that it can be easily repeated when following the outcome of gluten-free diet (GFD). Nevertheless, duodenal biopsy should be performed in any case, if the serology does not correlate with clinical symptoms. In such patients as well as in those revealing positive serology but negative and/or non-specific histology, immunogenetic typing should be performed in order to assess the expression of DQ2 [DQA*0501-DQB*0201] or DQ8 [DQA*0301-DQB1*0302] haplotypes of the human leukocyte antigen (HLA) class II region critical for the development of CD.

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Testing for Antireticulin Antibodies in Patients with Celiac Disease Is Obsolete: a Review of Recommendations for Serologic Screening and the Literature

Cited by 13 publications

References 44 publications

Prevalence of latent and overt polyautoimmunity in autoimmune thyroid disease: A systematic review and meta‐analysis

Prevalence of latent and overt polyautoimmunity in autoimmune thyroid disease: A systematic review and meta‐analysis

Immunological Approach of the Challenges of the XXI Century in Celiac Disease

The Malabsorption Syndrome versus Celiac Disease: A Diagnostic Reappraisal

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