Anti-endomysial antibody negative celiac disease - Does additional serological testing help?

被引:30
作者
Dahele, A
Kingstone, K
Bode, J
Anderson, D
Ghosh, S [1 ]
机构
[1] Western Gen Hosp, Gastrointestinal Unit, Dept Med Microbiol, Edinburgh EH4 2XU, Midlothian, Scotland
[2] Univ Edinburgh, Dept Med Sci, Gastrointestinal Unit, Edinburgh EH4 2XU, Midlothian, Scotland
关键词
anti-gliadin antibodies; anti-endomysium antibodies; anti-tissue transglutaminase antibodies; celiac disease;
D O I
10.1023/A:1005589202529
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Anti-endomysium antibodies (AEM) fail to identify all untreated celiac disease (CD) patients. This study aims to determine if additional serology, in particular, IgA anti-tissue transglutaminase (tTG) antibodies, increases detection. Fifty-three biopsy-proven untreated CD patients (39 women, 14 men; median age 51 years) and 65 control patients with normal duodenal histology (46 women, 19 men; age range 17-90 years, median 45 years) were prospectively studied. Serum total IgA, IgA anti-tTG, IgA AEM, IgA anti-gliadin (AGA) and IgG AGA antibodies were measured. Thirteen (25%) CD patients were AEM negative. None were IgA deficient. Three AEM-negative CD patients had a raised IgA anti-tTG and IgA AGA. IgG AGA was raised in 10 AEM-negative CD patients, but also in 14/65 (22%) of controls. In conclusion, AEM-negative CD is common and detection is only modestly enhanced by testing for IgA anti-tTG antibodies. Duodenal biopsy is still recommended for the accurate diagnosis of CD.
引用
收藏
页码:214 / 221
页数:8
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