title: Intestinal deposits of anti-tissue transglutaminase IgA in childhood celiac disease.
abstract: BACKGROUND
  High serum levels of anti-tissue-transglutaminase-2 IgA antibodies (anti-TG2), which are produced and deposited in the intestine, characterize celiac disease.
  
  
  OBJECTIVE
  To assess the diagnostic value of intestinal deposits of anti-TG2 IgA for celiac disease in a paediatric population.
  
  
  METHODS
  344 children underwent duodenal biopsy for the suspicion of CD, and were divided into 3 groups: group A, 144 celiac subjects with villous atrophy (Marsh 3b-c); group B, 109 subjects with high serum levels of anti-TG2 but normal intestinal mucosa (Marsh 0-1) (potential celiac disease patients); group C, 91 subjects with normal levels of serum anti-TG2: 70 with Marsh 0-1 and 21 with Marsh 3a mucosa. All duodenal sections were evaluated for the presence of intestinal deposits of anti-TG2 IgA by double immunofluorescence.
  
  
  RESULTS
  Deposits of anti-TG2 IgA were present in 96%, 68%, 12% of patients from groups A, B, C, respectively. Diagnostic sensitivity and specificity for celiac disease were 96% and 88% vs. 97% and 100% for serum anti-TG2, respectively. The degree of concordance with serum anti-TG2 was 85%.
  
  
  CONCLUSIONS
  Detection of intestinal deposits of anti-TG2 IgA is a useful diagnostic tool. Further research is needed regarding their ability to predict evolution to villous atrophy in potential celiac disease.
authors.affiliation: Department of Pediatrics and European Laboratory for the Investigation of Food-Induced Diseases, University "Federico II", Naples, Italy.
authors.forename: Mariantonia
authors.initials: M
authors.lastname: Maglio
authors.forename: Antonella
authors.initials: A
authors.lastname: Tosco
authors.forename: Renata
authors.initials: R
authors.lastname: Auricchio
authors.forename: Francesco
authors.initials: F
authors.lastname: Paparo
authors.forename: Barbara
authors.initials: B
authors.lastname: Colicchio
authors.forename: Erasmo
authors.initials: E
authors.lastname: Miele
authors.forename: Luciano
authors.initials: L
authors.lastname: Rapacciuolo
authors.forename: Riccardo
authors.initials: R
authors.lastname: Troncone
mesh_terms: D000293:Adolescent; D001323:Autoantibodies / Q000097:blood / Q000378:metabolism*; D002446:Celiac Disease / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D004386:Duodenum / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D019204:GTP-Binding Proteins; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood / Q000378:metabolism*; D007223:Infant; D007413:Intestinal Mucosa / Q000276:immunology* / Q000473:pathology; D011237:Predictive Value of Tests; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D012189:Retrospective Studies; D011503:Transglutaminases / Q000276:immunology*
chemical_list: D001323:Autoantibodies; D007070:Immunoglobulin A; C000717608:TGM2 protein, human; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases; D019204:GTP-Binding Proteins