Elution of antitransglutaminase antibodies from duodenal biopsies: a novel approach in the diagnosis of celiac disease.
Celiac disease (CeD) is a disease more prevalent and multisymptomatic than was earlier recognized. Whereas prompt initiation of gluten-free diet (GFD) is beneficial in relieving the symptoms, an accurate CeD diagnosis is necessary also to avoid years of restricted diet on uncertain grounds. We propose a new diagnostic method, based on elution of deposited antibodies against transglutaminase (anti-tTG) from duodenal biopsies in patients with symptoms and screening serology analyses suggestive of CeD. The eluates were analyzed in a Phadia 250 fluoroimmunoassay, demonstrating elevated concentrations of anti-tTG in CeD patients, corresponding to serology and histopathology findings. In one case histology was inconclusive, displaying only unspecific inflammation, but eluted anti-tTG was positive. This patient has clinically improved following GFD. We conclude that our novel method represents a new tool in the diagnostic work up in CeD. The detection of deposited anti-tTG at the site of inflammation appears to provide a high sensitivity and specificity using a technique that is quick, simple and reliable. Further studies are needed for optimization and elucidation of suitable applications for this elution method.
Department of Laboratory Medicine/Microbiology, Örebro University Hospital, Örebro, Sweden. sandra.rathsman@orebroll.se
Sandra
S
Rathsman
Curt
C
Tysk
Sune
S
Eriksson
Olof
O
Hultgren
Anna-Karin
AK
Aberg
Per
P
Olcén
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000906:Antibodies / Q000097:blood / Q000276:immunology*; D001706:Biopsy / Q000379:methods; D002446:Celiac Disease / Q000175:diagnosis* / Q000276:immunology* / Q000473:pathology; D055050:Diet, Gluten-Free / Q000379:methods; D004386:Duodenum / Q000276:immunology* / Q000473:pathology; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect / Q000379:methods; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood / Q000276:immunology; D008297:Male; D008875:Middle Aged; D012698:Serologic Tests / Q000379:methods; D011503:Transglutaminases / Q000276:immunology*; D055815:Young Adult
D000906:Antibodies; D007070:Immunoglobulin A; D011503:Transglutaminases