IgA anti-transglutaminase antibodies as a tool for screening atypical forms of coeliac disease in a French at-risk paediatric population.
OBJECTIVE
The diagnosis of coeliac disease (CD) is often delayed because many children are free from the major symptoms characteristic of this enteropathy. The aim of the present study was to determine the efficacy of antibodies directed against tissue transglutaminase (tTG Abs) for early detection of CD in a population with few symptoms of the disease, as well as in children with an autoimmune disorder.


METHODS
This was a prospective study in a paediatric population including 638 patients with clinical symptoms frequently associated with CD, autoimmune diseases such as type 1 diabetes mellitus (DM1), autoimmune thyroiditis or hepatitis, and Turner's syndrome. Anti-endomysium, tTG Abs and antigliadin antibodies were analysed in these patients using an indirect immunofluorescence technique and enzyme-linked immunosorbent assay techniques. Intestinal biopsies were performed for some patients with positive or negative antibodies.


RESULTS
tTG Abs were detected in 2.6% of children with symptoms associated with CD, such as digestive signs and growth failure, and in 5.4% of children with DM1. No other autoimmune disease was positive for tTG Abs. Biopsies performed in the patients with positive tTG Abs showed mucosal atrophy confirming the diagnosis of CD in all cases.


CONCLUSIONS
Children displaying minimal symptoms frequently associated with CD and children with DM1 should be systematically screened for tTG Abs.
Sakly
Wahiba
W
Department of Immunology, Lyon-Sud Hospital (CHLS), Hospices Civils de Lyon (HCL), Lyon, France.
Bienvenu
Françoise
F
Peretti
Noël
N
Lachaux
Alain
A
Morel
Stéphanie
S
Bouvier
Raymonde
R
Nicolino
Marc
M
Bienvenu
Jacques
J
Spiteri
Anne
A
Fabien
Nicole
N
D018798:Anemia, Iron-Deficiency / Q000209:etiology / Q000276:immunology; D001323:Autoantibodies / Q000032:analysis*; D001324:Autoantigens / Q000276:immunology; D001327:Autoimmune Diseases / Q000175:diagnosis; D015415:Biomarkers / Q000032:analysis; D002446:Celiac Disease / Q000150:complications / Q000175:diagnosis*; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000276:immunology; D005260:Female; D006130:Growth Disorders / Q000209:etiology / Q000276:immunology; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis*; D008297:Male; D008403:Mass Screening / Q000379:methods; D011446:Prospective Studies; D011503:Transglutaminases / Q000276:immunology*
D001323:Autoantibodies; D001324:Autoantigens; D015415:Biomarkers; D007070:Immunoglobulin A; D011503:Transglutaminases