title: Human umbilical cord as substrate for IgA antiendomysial antibodies allows large scale screening for celiac sprue.
abstract: Sera from 800 patients referred to our laboratory for celiac sprue screening were tested for IgA antiendomysial antibodies on human umbilical cord (HUC-EmA) and for IgA and IgG antigliadin antibodies (AGA) on rodent tissue by indirect immunofluorescence. Thirty-three patients (4.1%) were positive for at least one of the two antibodies; IgA HUC-EmA were found in 25 patients, whereas IgA and IgG AGA were detected in 19 and 24 subjects, respectively. Twenty-seven (82%) of the 33 patients with immunological markers showed sub-total or severe partial villous atrophy consistent with celiac sprue, whereas the remaining six cases had normal histological findings. None of 30 antibody-negative biopsied patients showed abnormalities of duodenal mucosa. Of the 27 newly diagnosed celiacs, only 21 (78%) were positive for IgA and/or IgG AGA, whereas IgA HUC-EmA were found in all but two cases (93%). In these two cases, positive only for IgG AGA, celiac sprue was associated with IgA deficiency. Our study proves that the routine use of IgA HUC-EmA increases celiac sprue findings by up to 15% when compared with AGA.
authors.affiliation: Istituto di Clinica Medica Generale e Terapia Medica, Università di Bologna, Policlinico S. Orsola, Italy.
authors.forename: U
authors.initials: U
authors.lastname: Volta
authors.forename: N
authors.initials: N
authors.lastname: Molinaro
authors.forename: L
authors.initials: L
authors.lastname: De Franceschi
authors.forename: F B
authors.initials: FB
authors.lastname: Bianchi
mesh_terms: D000328:Adult; D000906:Antibodies / Q000032:analysis; D002446:Celiac Disease / Q000175:diagnosis*; D002648:Child; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D005903:Gliadin / Q000276:immunology; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis*; D007074:Immunoglobulin G / Q000032:analysis; D008297:Male; D009130:Muscle, Smooth / Q000276:immunology; D009210:Myofibrils / Q000276:immunology*; D011933:Reagent Kits, Diagnostic; D014470:Umbilical Cord
chemical_list: D000906:Antibodies; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D011933:Reagent Kits, Diagnostic; D005903:Gliadin