Utility in Clinical Practice of Immunoglobulin A Anti-Tissue Transglutaminase Antibody for the Diagnosis of Celiac Disease

2006 ◽  
Vol 4 (6) ◽  
pp. 726-730 ◽  
Author(s):  
Julian A. Abrams ◽  
Pardeep Brar ◽  
Beverly Diamond ◽  
Heidrun Rotterdam ◽  
Peter H. Green
Keyword(s):  
Celiac Disease ◽  
Clinical Practice ◽  
Tissue Transglutaminase ◽  
Immunoglobulin A

scholarly journals Prevalence of Celiac Disease in Collagenous and Lymphocytic Colitis

2000 ◽  
Vol 14 (11) ◽  
pp. 919-921 ◽  
Author(s):  
Helen Rachel Gillett ◽  
Hugh James Freeman
Keyword(s):  
Celiac Disease ◽  
Small Bowel ◽  
Tissue Transglutaminase ◽  
Immunoglobulin A ◽  
Collagenous Colitis ◽  
Lymphocytic Colitis ◽  
Small Bowel Biopsy ◽  
Major Antigen ◽  
Immunofluorescent Technique ◽  
Endomysium Antibody

Both collagenous and lymphocytic colitis have been described in patients with celiac disease, suggesting an association between the conditions. Over the past few years, the availability, sensitivity and specificity of serological markers for celiac disease have improved - the most recent advancement being the description of tissue transglutaminase as the major antigen for endomysium antibody. A quantitative ELISA was used to measure titres of immunoglobulin A (IgA) antibody to tissue transglutaminase (tTG) along with an immunofluorescent technique for IgA endomysium antibody (EmA) in 15 patients with lymphocytic colitis and eight with collagenous colitis to determine whether celiac disease latency could be detected. One patient with lymphocytic colitis demonstrated both elevated titres of tTG antibody and positive EmA, and small bowel biopsy confirmed celiac disease. One patient with collagenous colitis had a slightly elevated titre of tTG antibody with a negative EmA, and results of a small bowel biopsy were normal. Three other patients with lymphocytic colitis were already treated for previously diagnosed celiac disease. The prevalence of celiac disease occurring in lymphocytic colitis was found to be 27%, but no cases of celiac disease in association with collagenous colitis were found.

scholarly journals Testing for Gluten-Related Disorders in Clinical Practice: The Role of Serology in Managing the Spectrum of Gluten Sensitivity

2011 ◽  
Vol 25 (4) ◽  
pp. 193-197 ◽  
Author(s):  
David Armstrong ◽  
Andrew C Don-Wauchope ◽  
Elena F Verdu
Keyword(s):  
Celiac Disease ◽  
Serological Test ◽  
Tissue Transglutaminase ◽  
Immunoglobulin A ◽  
Intestinal Damage ◽  
Gluten Sensitivity ◽  
Serological Testing ◽  
Diet Compliance ◽  
At Risk Populations ◽  
Irritable Bowel

Immunoglobulin A tissue transglutaminase is the single most efficient serological test for the diagnosis of celiac disease. It is well known that immunoglobulin A tissue transglutaminase levels correlate with the degree of intestinal damage, and that values can fluctuate in patients over time. Serological testing can be used to identify symptomatic individuals that need a confirmatory biopsy, to screen at-risk populations or to monitor diet compliance in patients previously diagnosed with celiac disease. Thus, interpretation of serological testing requires consideration of the full clinical scenario. Antigliadin tests are no longer recommended for the diagnosis of classical celiac disease. However, our understanding of the pathogenesis and spectrum of gluten sensitivity has improved, and gluten-sensitive irritable bowel syndrome patients are increasingly being recognized. Studies are needed to determine the clinical utility of antigliadin serology in the diagnosis of gluten sensitivity.

scholarly journals Positive Celiac Disease Serology and Reduced Bone Mineral Density in Adult Women

2010 ◽  
Vol 24 (2) ◽  
pp. 103-107 ◽  
Author(s):  
Donald R Duerksen ◽  
William D Leslie
Keyword(s):  
Celiac Disease ◽  
Bone Density ◽  
Tissue Transglutaminase ◽  
Immunoglobulin A ◽  
The United States ◽  
Study Cohort ◽  
Adult Women ◽  
Mineral Density ◽  
Density Measurements ◽  
Prevalence Of Osteoporosis

BACKGROUND: Low bone density and osteoporosis have been demonstrated in celiac disease populations in Europe, South America and the United States. Serological testing with tissue transglutaminase (TTG) and immunoglobulin A endomysial (EMA) antibodies is highly specific for celiac disease, while antigliadin antibody (AGA) testing is less specific.OBJECTIVE: To evaluate the association of celiac serology with reduced bone density in adult women.METHODS: A clinical database containing all bone density testing data in the province of Manitoba was linked to a database containing all celiac serology data for the province. The study cohort consisted of 376 women older than 20 years of age with bone density measurements preceding initial celiac serology by six months or less. Bone density was assessed in relation to TTG/EMA and AGA seropositivity, and compared with seronegative controls in age-, height- and weight-adjusted models.RESULTS: There was significantly lower bone density in TTG/EMA seropositive women than with seronegative controls for all sites tested (lumbar spine, total hip, trochanter, femoral neck; all P<0.05). TTG/EMA seropositive women also had a significantly higher prevalence of osteoporosis (67.7% versus 44.8%; P<0.05). There was lower bone density at the three hip sites (all P<0.05) in AGA seropositive women, but after excluding TTG/EMA seropositive women, isolated AGA seropositivity showed no significant association with any bone density measurements.CONCLUSION: TTG/EMA seropositivity was associated with lower bone density and a higher prevalence of osteoporosis compared with seronegative controls.

scholarly journals Increased Prevalence of Celiac Disease in Girls with Turner Syndrome Detected Using Antibodies to Endomysium and Tissue Transglutaminase

2000 ◽  
Vol 14 (11) ◽  
pp. 915-918 ◽  
Author(s):  
PM Gillett ◽  
HR Gillett ◽  
DM Israel ◽  
DL Metzger ◽  
L Stewart ◽  
...  
Keyword(s):  
British Columbia ◽  
Celiac Disease ◽  
Small Bowel ◽  
Turner Syndrome ◽  
Tissue Transglutaminase ◽  
Immunoglobulin A ◽  
The Novel ◽  
East Indian ◽  
High Prevalence ◽  
Endomysium Antibody

OBJECTIVE: To establish the prevalence of celiac disease (CD) in girls with Turner syndrome (TS) in British Columbia.METHODS: Forty-five girls with TS were prospectively screened for CD using blinded testing with the current ’gold standard’ - immunoglobulin A (IgA) endomysium antibody (EmA) and the novel IgA tissue transglutaminase antibody (tTG). Those with positive results were offered small bowel biopsies, and a gluten-free diet was recommended if CD was confirmed.RESULTS: One asymptomatic prepubertal East Indian girl was positive for EmA, had an elevated tTG concentration of 560 U/mL and histological evidence of CD. Seven girls were negative for EmA but had elevated tTG concentrations (175 to 250 U/mL); five were white, one was Asian and one was East Indian. Small bowel biopsies were performed on three girls, and the histologies were normal. The remaining four patients declined biopsy.CONCLUSIONS: One girl with TS was identified with CD from 45 screened, giving an overall biopsy-confirmed prevalence of 2.2%. This study confirms previous observations placing girls with TS at higher risk for CD and suggests a similar high prevalence in British Columbia.

scholarly journals Clinical Onset of Celiac Disease after an Episode ofCampylobacter jejuniEnteritis

2007 ◽  
Vol 21 (7) ◽  
pp. 453-455 ◽  
Author(s):  
EF Verdu ◽  
M Mauro ◽  
J Bourgeois ◽  
D Armstrong
Keyword(s):  
Celiac Disease ◽  
Tissue Transglutaminase ◽  
Present Report ◽  
Immunoglobulin A ◽  
Antibody Test ◽  
Susceptible Host ◽  
Vitamin Deficiencies ◽  
Clinical Onset ◽  
Infectious Gastroenteritis ◽  
Repeat Endoscopy

The present report describes a young woman with no previous gastrointestinal complaints who was initially diagnosed with postinfective irritable bowel syndrome (IBS) after a confirmed case ofCampylobacter jejunienteritis. However, because of persistent diarrhea, new-onset bloating and the development of iron and vitamin deficiencies, serological markers for celiac disease (CD) were evaluated. A positive tissue transglutaminase immunoglobulin A antibody test and repeat endoscopy with duodenal biopsy showing a Marsh IIIa lesion confirmed the diagnosis of CD. Infectious gastroenteritis is a well-established risk factor for the development of IBS, and there is recent evidence that it could play a role in the initiation and exacerbation of inflammatory bowel disease. The present case suggests that the clinical expression of CD can be unmasked by an acute gastrointestinal infection and supports the hypothesis that environmental factors other than gliadin may play a role in the clinical onset of CD in a genetically susceptible host. The increasing availability of serological testing and upper endoscopy has led to increasingly frequent diagnoses of CD and recognition that it may mimic IBS. The present case findings suggest that CD should be considered in the differential diagnosis of persistent IBS-like symptoms after an episode of infectious gastroenteritis.

scholarly journals High Prevalence of Celiac Disease in Patients with Type 1 Diabetes Detected by Antibodies to Endomysium and Tissue Transglutaminase

2001 ◽  
Vol 15 (5) ◽  
pp. 297-301 ◽  
Author(s):  
PM Gillett ◽  
HR Gillett ◽  
DM Israel ◽  
DL Metzger ◽  
L Stewart ◽  
...  
Keyword(s):  
British Columbia ◽  
Type 1 Diabetes ◽  
Celiac Disease ◽  
Growth Parameters ◽  
Morphological Changes ◽  
Tissue Transglutaminase ◽  
Immunoglobulin A ◽  
Gluten Free Diet ◽  
Gluten Free

OBJECTIVE: To establish the prevalence of celiac disease (CD) in children with type 1 diabetes in British Columbia.PATIENTS AND METHODS: Two hundred thirty-three children with type 1 diabetes were prospectively screened for CD using blind testing with the current 'gold standard', immunoglobulin A endomysium antibody (EmA), and the novel immunoglobulin A tissue transglutaminase (tTG) antibody. Those children with positive results were offered small bowel biopsy; a gluten-free diet was recommended if CD was confirmed.RESULTS: Nineteen children were positive for EmA and had an elevated tTG level. One patient from this group was already known to have CD, and the other 18 patients consented to biopsy. One biopsy was normal, three biopsies demonstrated elevated intraepithelial lymphocyte counts with normal morphology and 14 biopsies had morphological changes consistent with CD. Growth parameters were normal in all patients, and nine of 19 children who were positive for EmA were asymptomatic. Seven patients had mild elevation of tTG levels alone. Two children from this latter group had normal biopsies, and five declined biopsy.CONCLUSIONS: At least 14 new cases of CD were detected in addition to four known cases, yielding an overall biopsy-confirmed prevalence of CD of 7.7% (18 of 233). The present study confirms that CD is as prevalent in the pediatric type 1 diabetic population in British Columbia as it is in Europe. Serological screening of these children is important because many children have no symptoms or signs suggestive of CD. This study suggests that tTG serology may also be useful in monitoring response and compliance with a gluten-free diet.

The relation between ischemia modified albumin level and autoimmunity/chronic inflammation in celiac disease

2017 ◽  
Vol 42 (3) ◽  
Author(s):  
Mahmut Yuksel ◽  
Mustafa Kaplan ◽  
Ihsan Ates ◽  
Yasemin Ozderin Ozin ◽  
Hasan Kilic ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Chronic Inflammation ◽  
Immunoglobulin G ◽  
Tissue Transglutaminase ◽  
Immunoglobulin A ◽  
Chronic Inflammatory Disease ◽  
Albumin Level ◽  
Control Group ◽  
Ischemia Modified Albumin ◽  
Gliadin Antibodies

AbstractObjective:We established an expectation that ischemia-modified albumin (IMA) levels are higher in the celiac disease since it is an autoimmune/chronic inflammatory disease. In this study, we determined the level of IMA and its relation to autoimmunity/chronic inflammation in celiac disease.Material and methods:The level of IMA of 65 patients diagnosed with celiac disease and 65 healthy volunteers, was measured with the serum ELISA kit. C-reactive protein (CRP), anti-gliadin antibodies immunoglobulin A (AGA-lgA), anti-gliadin antibodies immunoglobulin G (AGA-lgG), anti-tissue transglutaminase immunoglobulin A antibodies (Anti-t-TGA), anti-tissue transglutaminase immunoglobulin G antibodies (Anti-t-TGG) levels were studied.Results:IMA (30.8 ng/mL vs. 20.1 ng/mL, p=0.006; respectively) levels in celiac patients were higher than the control group. In celiac patients who were antibody positive, IMA level was found to be higher compared to antibody negative patients. A positive correlation was determined between IMA level and AGA-IgA (r=0.504, p<0.001), AGA-IgG (r=0.445, p<0.001), Anti-t TGA (r=0.485, p<0.001), Anti-t TGG (r=0.477, p<0.001) and CRP (r=0.385, p=0.011) levels.Conclusion:Chronic inflammation and autoimmunity were found to be associated with high levels of IMA. To use IMA as a diagnosis and follow-up criterion in celiac disease, IMA levels must be compared before and after treatment of active celiac disease.

scholarly journals Immunoglobulin G (IgG) Anti-Tissue Transglutaminase Antibodies Used as Markers for IgA-Deficient Celiac Disease Patients

2005 ◽  
Vol 12 (2) ◽  
pp. 254-258 ◽  
Author(s):  
Ingrid Dahlbom ◽  
Martin Olsson ◽  
Nahal Kazemi Forooz ◽  
Anders G. Sjöholm ◽  
Lennart Truedsson ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Tissue Transglutaminase ◽  
Immunoglobulin A ◽  
Good Alternative ◽  
Iga Deficiency ◽  
Enzyme Linked Immunosorbent Assay ◽  
Screening Methods ◽  
Igg Antibodies ◽  
Negative Results ◽  
Tissue Transglutaminase Antibodies

ABSTRACT The role of immunoglobulin A (IgA) anti-tissue transglutaminase antibodies (IgA-tTG) as predictors of untreated celiac disease (CoD) is well documented, and the presence and levels of these antibodies are most accurately monitored with native or recombinant human antigens. However, IgA-deficient CoD patients are not identified by IgA serology, and conflicting results concerning the diagnostic validity of IgG antibodies against gliadin (IgG-AGA), endomysium (IgG-EmA), and tTG (IgG-tTG) have been reported. The aim of the present study was to evaluate the utility of IgG-tTG for the detection of CoD in IgA-deficient patients. Samples from 115 IgA-deficient and 200 IgA-sufficient subjects were collected and tested for the presence of IgA and IgG antibodies against tTG, EmA, and AGA. Antibodies against tTG were measured by an enzyme-linked immunosorbent assay based on recombinant human tTG, and antibodies against EmA were determined by immunofluorescence. The values for IgG-tTG showed a higher correlation (correlation coefficient [r] = 0.91) with those for IgG-EmA for the IgA-deficient subjects than for the IgA-sufficient subjects (r = 0.88). The overall concordance of the positive and negative results between IgG-tTG and IgG-EmA was 97%, and the IgG-tTG assay discriminated between IgG-EmA-positive and -negative subjects with IgA deficiency at a rate of 100%. Elevated levels of IgG-tTG and IgG-EmA were measured in 70% of the IgA-sufficient subjects. IgG-tTG detection with recombinant human tTG is a good alternative to IgG-EmA detection, and the addition of IgG-tTG assessment to present screening methods may improve the ability to identify IgA-deficient subjects with CoD.

Sa1433 Role of Immunoglobulin A and Tissue Transglutaminase IgG in Celiac Disease Evaluation

2016 ◽  
Vol 150 (4) ◽  
pp. S314
Author(s):  
Rok Seon Choung ◽  
John R. Mills ◽  
Manish J. Gandhi ◽  
Joseph A. Murray ◽  
Melissa Snyder
Keyword(s):  
Celiac Disease ◽  
Tissue Transglutaminase ◽  
Immunoglobulin A
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