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Aust N Z J Med. 1999 Apr;29(2):239-42.

Anti-transglutaminase antibodies and coeliac disease.

Author information

1
Department of Gastroenterology, St Vincent's Hospital, Melbourne, Vic.

Abstract

BACKGROUND:

Anti-endomysial antibodies have high specificity for coeliac disease but measurements are limited by the requirement for monkey oesophagus, a substrate that is expensive, and of limited availability and ethical acceptance. Tissue transglutaminase has recently been identified as the endomysial autoantigen in coeliac disease.

AIMS:

To examine the validity of serum tissue transglutaminase antibody levels in patients with coeliac disease and to assess their sensitivity and specificity against standard serological tests.

METHODS:

Serum IgA anti-tissue transglutaminase antibody titres (measured by ELISA), IgA anti-gliadin antibody titres (measured by a commercial ELISA) and anti-endomysial antibody titres (measured by indirect immunofluorescence) were determined in 46 untreated and 14 treated patients biopsy-proven coeliac disease and 145 disease and healthy controls.

RESULTS:

All patients with untreated coeliac disease were positive for anti-endomysial and anti-tissue transglutaminase antibodies (sensitivity 100%). Seventy-one per cent of treated coeliac patients were anti-tissue transglutaminase antibody negative. Five of 145 disease and healthy controls had low titres of anti-tissue transglutaminase antibody (specificity 97%); no controls were anti-endomysial antibody positive.

CONCLUSIONS:

Our results demonstrated the sensitivity and specificity of IgA anti-tissue transglutaminase antibodies to correlate highly with anti-endomysial antibodies in the diagnosis of coeliac disease. The ELISA for IgA anti-tissue transglutaminase antibodies is quantitative and easy to perform and is a valid alternative to indirect immunofluorescence for anti-endomysial antibodies in screening for suspected coeliac disease.

[Indexed for MEDLINE]

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