[Diagnostic validity of anti-tissue transglutaminase and anti-endomysium antibodies in children with celiac disease].
Tissue transglutaminase (tTG) plays a decisive role in the pathomechanism of celiac disease. Unchanged gliadin peptides bind to HLA-DQ2 with a week affinity, after that they are recognized by gliadin specific T-lymphocytes and the whole immune reaction is started which damages intestine mucous and causes the release of tTG. Tissue transglutaminase deaminates gliadin peptides enhancing the whole process. The aim of this study was determination of correlation between antiendomysial antibodies and anti-tissue transglutaminase antibodies in children with celiac disease, and the assessment of their usefulness in the diagnosis of celiac disease.


METHODS
109 children, aged 6 moths to 16 years (average 8.8 years) were included into the study. In all children an intestine biopsy was performed and/or antiendomysial antibodies were determined. In all children tissue transglutaminase antibodies were measured. Antibodies against tissue transglutaminase were determined using ELISA method. Antiendomysial antibodies were determined using the immunofluorescence method.


RESULTS
In patients with normal mucous with lack of lymphocyte infiltration no IgAEmA were present in the blood. In the groups with subtotal and total villous atrophy all IgAEmA titres were positive. A positive titre of IgAEmA was observed only in childrerl with villous atrophy, which yields specificity of the test of 100%, sensitivity was 81%. Sensitivity of the anti-tTG antibodies test for detecting villous atrophy was 83% for IgA and 52% for IgG. There is a positive correlation between IgAEmA and anti-tTG antibodies.


CONCLUSIONS
High sensitivity and specificity of determination of antibodies against tTG in IgA class causes that these tests may serve as a screening test in diagnosis and monitoring of celiac disease in children.
Matusiewicz
Krzysztof
K
Akademia Medyczna we Wroclawiu, II Katedra i Klinika Pediatrii, Gastroenterologii i Zywienia.
Iwańczak
Barbara
B
Matusiewicz
Małgorzata
M
Iwańczak
Franciszek
F
D000293:Adolescent; D000888:Antibodies, Anti-Idiotypic / Q000276:immunology*; D001706:Biopsy; D002446:Celiac Disease / Q000201:enzymology* / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005455:Fluorescent Antibody Technique; D006683:HLA-DQ Antigens / Q000276:immunology; D006801:Humans; D007070:Immunoglobulin A / Q000276:immunology; D007223:Infant; D007413:Intestinal Mucosa / Q000378:metabolism / Q000473:pathology; D008297:Male; D018485:Muscle Fibers, Skeletal / Q000276:immunology*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D011503:Transglutaminases / Q000378:metabolism*
D000888:Antibodies, Anti-Idiotypic; D006683:HLA-DQ Antigens; C053186:HLA-DQ2 antigen; D007070:Immunoglobulin A; D011503:Transglutaminases; C105804:transglutaminase 1