Endomysial antibodies predict celiac disease irrespective of the titers or clinical presentation

AIM：To investigate the association between serum antibody levels and a subsequent celiac disease diag-nosis in a large series of children and adults. METHODS：Besides subjects with classical gastrointestinal presentation of celiac disease,the study cohort included a substantial number of individuals...

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Published inWorld journal of gastroenterology : WJG Vol. 18; no. 20; pp. 2511 - 2516
Main Author Kurppa, Kalle
Format Journal Article
LanguageEnglish
Published United States Baishideng Publishing Group Co., Limited 28.05.2012
Subjects
Adolescent
Adult
Aged
Autoantibodies - blood
Brief
Celiac Disease - blood
Celiac Disease - diagnosis
Celiac Disease - pathology
Child
Child, Preschool
Connective Tissue - immunology
Female
GTP-Binding Proteins - immunology
Humans
Immunoglobulin A - blood
Infant
Intestinal Mucosa - immunology
Intestine, Small - immunology
Male
Middle Aged
Muscle, Smooth - immunology
Transglutaminases - immunology
Young Adult
临床表现
内膜
抗体水平
滴度
疾病诊断
腹腔
转谷氨酰胺酶
预测
Celiac disease
Transglutaminase 2 antibodies
Diagnosis
Clinical presentations
Endomysial antibodies
Online AccessGet full text
ISSN1007-9327
2219-2840
2219-2840
DOI10.3748/wjg.v18.i20.2511

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Summary:AIM：To investigate the association between serum antibody levels and a subsequent celiac disease diag-nosis in a large series of children and adults. METHODS：Besides subjects with classical gastrointestinal presentation of celiac disease,the study cohort included a substantial number of individuals with extraintestinal symptoms and those found by screening in at-risk groups.Altogether 405 patients underwent clinical,serological and histological evaluations.After collection of data,the antibody values were further graded as low[endomysial（EmA）1：5-200,transglutaminase 2 antibodies（TG2-ab）5.0-30.0 U/L]and high （EmA 1：≥500,TG2-ab≥30.0 U/L）,and the serological results were compared with the small intestinal mucosal histology and clinical presentation. RESULTS：In total,79%of the subjects with low and 94%of those with high serum EmA titers showed small-bowel mucosal villous atrophy.Furthermore, 96%of the 47 EmA positive subjects who had normal mucosal villi and remained on follow-up either subsequently developed mucosal atrophy while on a glutencontaining diet,or responded positively to a glutenfree diet. CONCLUSION：Irrespective of the initial serum titers or clinical presentation,EmA positivity as such is a very strong predictor of a subsequent celiac disease diagnosis.
Bibliography:Celiac disease; Diagnosis; Endomysial antibodies; Transglutaminase 2 antibodies; Clinical presentations
AIM：To investigate the association between serum antibody levels and a subsequent celiac disease diag-nosis in a large series of children and adults. METHODS：Besides subjects with classical gastrointestinal presentation of celiac disease,the study cohort included a substantial number of individuals with extraintestinal symptoms and those found by screening in at-risk groups.Altogether 405 patients underwent clinical,serological and histological evaluations.After collection of data,the antibody values were further graded as low[endomysial（EmA）1：5-200,transglutaminase 2 antibodies（TG2-ab）5.0-30.0 U/L]and high （EmA 1：≥500,TG2-ab≥30.0 U/L）,and the serological results were compared with the small intestinal mucosal histology and clinical presentation. RESULTS：In total,79%of the subjects with low and 94%of those with high serum EmA titers showed small-bowel mucosal villous atrophy.Furthermore, 96%of the 47 EmA positive subjects who had normal mucosal villi and remained on follow-up either subsequently developed mucosal atrophy while on a glutencontaining diet,or responded positively to a glutenfree diet. CONCLUSION：Irrespective of the initial serum titers or clinical presentation,EmA positivity as such is a very strong predictor of a subsequent celiac disease diagnosis.
Kalle Kurppa,Tiia Rsnen,Sari Iltanen,Merja Ashorn, Markku Mki,Pediatric Research Centre,University of Tampere and Tampere University Hospital,Fin-33014,Tampere, Finland Pekka Collin,Katri Kaukinen,Department of Gastroenterology and Alimentary Tract Surgery,Tampere University Hospital and School of Medicine,University of Tampere,Fin-33014, Tampere,Finland Heini Huhtala,Tampere School of Public Health,University of Tampere,Fin-33014,Tampere,Finland Pivi Saavalainen,Department of Medical Genetics and Research Program for Molecular Medicine,University of Helsinki, Fin-00014,Helsinki,Finland Katri Haimila,Jukka Partanen,Research and Development, Finnish Red Cross Blood Service,Fin-00310,Helsinki,Finland
14-1219/R
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Telephone: +358-3-35518403 Fax: +358-3-35518402
Correspondence to: Katri Kaukinen, MD, PhD, Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital and School of Medicine, University of Tampere, Fin-33014, Tampere, Finland. katri.kaukinen@uta.fi
Author contributions: Kurppa K, Räsänen T, Collin P, Iltanen S, Huhtala H, Ashorn M, Saavalainen P, Haimila K, Partanen J, Mäki M and Kaukinen K designed the research, contributed to the acquisition of the data and performed critical revision of the manuscript; Kurppa K, Huhtala H and Kaukinen K analyzed the data; Kurppa K and Kaukinen K wrote the paper.
ISSN:1007-9327
2219-2840
2219-2840
DOI:10.3748/wjg.v18.i20.2511