IgA antibodies to tissue transglutaminase: An effective diagnostic test for celiac disease☆,☆☆,★
Section snippets
Patients
We examined serum samples from 111 patients with suspected celiac disease; 48 (20 male and 28 female, mean age 5.7 years, ranging from 0.9 to 20 years) met the revised ESPGAN criteria for celiac disease.8 The remaining symptom-matched 63 patients (32 male and 31 female, mean age 4.2 years, ranging from 1.1 to 17 years) received a diagnosis of chronic nonspecific diarrhea (n = 16), failure to thrive (n = 14), Crohn’s disease (n = 10), cow’s milk protein allergy (n = 5), gastroesophageal reflux
IgA to tTG
In untreated patients with celiac disease, values of IgA to tissue tTG (mean 72.3, interquartile range, 32.3 to 117.8) were significantly (P < .001) higher than those in treated patients (mean 3.8, interquartile range 0 to 3.5) or those in subjects in the disease control group (mean 1.9, interquartile range 0 to 3.0) (Fig 1).
DISCUSSION
The recent demonstration by Dieterich et al7 that tissue tTG is the predominant, if not the sole, autoantigen recognized by endomysial antibodies prompted us to develop an ELISA method for the diagnosis of celiac disease. The protocol used was very similar to that used by Dieterich et al,7 but because preliminary experiments showed frequent “false” positive results, we decided to avoid the use of bovine serum albumin as a blocking agent, because it is a food antigen against which patients with
Acknowledgements
We thank Jean Gilder for editing the text.
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Supported by grants from the Regione Campania, Naples, Italy; Istituto Superiore di Sanità, Rome, Italy; PRIN, MURST, Rome, Italy.
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Reprint requests: Riccardo Troncone, MD, Dipartimento di Pediatria, Università Federico II, via Sergio Pansini 5, I-80131 Napoli, Italy.
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