IgA- and IgG-class antihuman umbilical cord antibody tests in adult coeliac disease.
BACKGROUND
An antiendomysium antibody test using human umbilical cord as antigen has recently been introduced.


METHODS
We determined IgA- and IgG-class antihuman umbilical cord (HUC-ab), antireticulin (ARA), and antigliadin antibodies (AGA) in 92 untreated adult coeliac patients, in 95 non-coeliac subjects, and in 4 coeliac patients with selective IgA deficiency. Tissue antibodies were measured with an indirect immunofluorescence method and AGA with an enzyme-linked immunosorbent assay.


RESULTS
Of adult coeliac patients 85% were positive for IgA-class HUC-ab, 78% were positive for ARA, and 80% for AGA; the specificity for HUC-ab and ARA was 100%, and for AGA 86%. Combination of HUC-ab, ARA, and high-titre AGA increased the sensitivity to 96% without loss of specificity. IgG-class HUC-ab was positive in 12% of coeliac patients, in all four coeliac patients with IgA deficiency, and in none of the controls.


CONCLUSIONS
The HUC-ab test is highly specific but not 100% sensitive for detecting adult coeliac disease. A combination of the IgA-class HUC-ab, ARA, and high-titre AGA tests is recommended. In selective IgA deficiency the IgG-class HUC-ab test seems to work well.
Sulkanen
S
S
Institute of Medical Technology and Medical School, University of Tampere, Finland.
Collin
P
P
Laurila
K
K
Mäki
M
M
D000328:Adult; D000368:Aged; D000906:Antibodies / Q000032:analysis; D000888:Antibodies, Anti-Idiotypic / Q000032:analysis; D002446:Celiac Disease / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay; 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; D008875:Middle Aged; D012155:Reticulin / Q000276:immunology; D012680:Sensitivity and Specificity; D014470:Umbilical Cord / Q000276:immunology*
D000906:Antibodies; D000888:Antibodies, Anti-Idiotypic; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D012155:Reticulin; D005903:Gliadin