ELISA of anti-endomysial antibodies in the diagnosis of celiac disease: comparison with immunofluorescence assay of anti-endomysial antibodies and tissue transglutaminase antibodies.
BACKGROUND
Celiac disease is common in both children and adults. Small intestinal biopsy is mandatory for establishing a diagnosis. Anti-endomysial antibodies, detected by immunofluorescence, have a sensitivity and specificity close to 100% in the diagnosis of CD. Recently, tissue transglutaminase has been identified as the target autoantigen of antibodies against endomysium, and TTG antibodies are comparable to EMA-IMF in the diagnosis of CD.


OBJECTIVE
To evaluate a new enzyme-linked immunosorbent assay kit for EMA, compared to EMA-IMF and TTG antibodies in the diagnosis of CD.


METHODS
Our study population included all subjects with positive EMA-IMF who underwent intestinal biopsy (n = 21). From the same sera, TTG antibodies and EMA-ELISA were determined, and all antibody results were compared to the biopsy findings.


RESULTS
EMA-IMF was able to predict biopsy findings of CD in 19 of 21 cases (90.5%). When patients with biopsy findings compatible with CD and positive EMA-IMF (n = 19) were tested for EMA-ELISA and TTG antibodies, 18 of the 19 were positive for both EMA-ELISA and TTG antibodies. A significant correlation was found between EMA-ELISA and TTG antibody titers (r = 0.74, P < 0.001).


CONCLUSIONS
Our study demonstrates that EMA-ELISA is comparable to TTG antibodies in the diagnosis of CD, and supports the use of EMA-ELISA as a serologic marker for this disease.
Division of Pediatric Gastroenterology and Nutrition, Department of Pediatrics, Rambam Medical Center, Haifa, Israel. shamirr@netvision.net.il
Raanan
R
Shamir
Rami
R
Eliakim
Nitza
N
Lahat
Esther
E
Sobel
Aaron
A
Lerner
D001323:Autoantibodies / Q000097:blood*; D002446:Celiac Disease / Q000175:diagnosis* / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay; D005455:Fluorescent Antibody Technique; D006801:Humans; D007413:Intestinal Mucosa / Q000276:immunology; D011503:Transglutaminases / Q000097:blood*
D001323:Autoantibodies; D011503:Transglutaminases