Is immunoglobulin A anti-tissue transglutaminase antibody a reliable serological marker of coeliac disease?
Eur J Gastroenterol Hepatol
; 16(5): 467-70, 2004 May.
Article
em En
| MEDLINE
| ID: mdl-15097038
ABSTRACT
BACKGROUND:
Anti-tissue transglutaminase (tTG) antibody is being used increasingly as a diagnostic tool in the serological investigation of coeliac disease. However, positive predictive values of immunoglobulin A (IgA) anti-tTG for coeliac disease in prospective studies have been disappointing and false-positive results are reported.OBJECTIVE:
To assess the clinical utility of cascade testing for anti-tTG and anti-endomysium antibody (AEA). PATIENTS Two unselected retrospective cohorts from routine diagnostic investigation for possible gluten sensitive enteropathy group 1 comprised 57 cases seropositive for anti-tTG and group 2 comprised 52 cases seronegative for anti-tTG. In both groups, all cases had also undergone small-intestinal biopsy.METHODS:
Patients were assessed for the presence of IgA anti-tTG by enzyme-linked immunosorbent assay and for IgA AEA by immunofluorescence.RESULTS:
The positive predictive value of IgA anti-tTG for biopsy-confirmed coeliac disease was 54%. The positive predictive value of dual positivity for anti-tTG and AEA was 97%. The negative predictive value of IgA anti-tTG was 100%.CONCLUSIONS:
The data presented here support the use of IgA anti-tTG as an initial screen for coeliac disease. Coeliac disease is unlikely when IgA anti-tTG is absent. However, many false-positive results are seen, and clinical utility and diagnostic efficiency are improved markedly if positive results are confirmed with the more accurate, but labour-intensive, AEA assay.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Imunoglobulina A
/
Doença Celíaca
/
Transglutaminases
/
Proteínas de Ligação ao GTP
/
Anticorpos
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2004
Tipo de documento:
Article