title: [Tissue anti-transglutaminase antibodies: a better test to detect minor dietary transgressions in celiac patients?].
abstract: BACKGROUND
  Endomysium antibodies (EMA) do not detect minor dietary transgressions in patients with celiac disease.
  
  
  OBJECTIVE
  To compare the sensitivity and specificity of tissue transglutaminase antibodies (tTGA) and endomysium antibodies (EMA) in biopsy proven celiac patients at the time of diagnosis and during gluten free diet (GFD).
  
  
  METHODS
  One hundred fifty three subjects were studied: a) 30 healthy controls; b) 9 cases with cow's milk allergy; c) 24 celiac patients at time of diagnosis; d) 25 celiac patients adhering to the GFD; e) 65 celiac patients with poor/no adhesion to GFD. EMA and tTGA IgA were measured by immunofluorescence and ELISA, respectively.
  
  
  RESULTS
  Sensitivity and specificity were 100% and 97.4% for tTGA, respectively. All patients with cow's milk allergy were EMA (-) and 8 of 9 (88.9%) were tTGA (-). In celiac patients not adhering to the GFD, EMA and tTGA positivity were similar (80% and 81.5%, respectively); 95.4% of the subjects tested positive for at least one of them. All patients adhering to GFD were EMA (-) but tTGA were (+) in 28% of them.
  
  
  CONCLUSIONS
  EMA and tTGA have similar sensitivity and specificity at the time of diagnosis of celiac disease. Positive tTGA in 28% of patients that adhered strictly to the GFD and whose EMA were negative suggest that tTGA may be helpful in detecting minor dietary transgressions and should be further evaluated.
authors.affiliation: Area de Nutrición Humana y Clínica, Instituto de Nutrición y Tecnología de los Alimentos (INTA), Universidad de Chile, Santiago, Chile. mgottela@uec.inta.uchile.cl
authors.forename: Martin
authors.initials: M
authors.lastname: Gotteland
authors.forename: Sandra
authors.initials: S
authors.lastname: Verbeke
authors.forename: Sylvia
authors.initials: S
authors.lastname: Cruchet
authors.forename: Oscar
authors.initials: O
authors.lastname: Brunser
authors.forename: Gloria
authors.initials: G
authors.lastname: Ríos
authors.forename: Bessy
authors.initials: B
authors.lastname: Hunter
authors.forename: Magdalena
authors.initials: M
authors.lastname: Araya
mesh_terms: D000293:Adolescent; D000328:Adult; D000918:Antibody Specificity; D002446:Celiac Disease / Q000175:diagnosis / Q000178:diet therapy* / Q000201:enzymology; D002648:Child; D002675:Child, Preschool; D004032:Diet; D005260:Female; D019204:GTP-Binding Proteins / Q000276:immunology*; D005983:Glutens; D006801:Humans; D007070:Immunoglobulin A / Q000276:immunology*; D007223:Infant; D008297:Male; D016269:Milk Hypersensitivity / Q000201:enzymology / Q000276:immunology; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D012680:Sensitivity and Specificity; D011503:Transglutaminases / Q000276:immunology*
chemical_list: D007070:Immunoglobulin A; D005983:Glutens; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases; D019204:GTP-Binding Proteins