Quantification of serum IgA of coeliac disease patients

ABSTRACT

Celiac disease [CD] is a gluten - induced multi - organ disorder where small intestine is the primary target of inflammation. Onset of CD may occur at any age and its symptoms vary among individuals. Definitive diagnosis of CD is by intestinal biopsy but determination of anti - IgA tissue transglutaminase [tTG] and anti-gliadin antibodies has become key factors to decide for tissue biopsy. IgA - deficient CD patients may yield false - negative results, therefore total serum IgA level must be determined along with other serological markers to diagnose CD. The study included 42 CD patients who were positive for anti-tTg antibodies [Group A] and 40 subjects [Group B disease control] presented with gastrointestinal complaints but were negative for anti-tTG antibodies. On the basis of age, Group A was further divided into Sub-group- I comprised of patients between 1-6 years [n = 31] and Sub-group - II consisted of patients between 7-15 years [n=11]. Level of serum IgA was determined by nephlometry technique. Total serum IgA level was 38.77 +/- 31.21 mg/dl and 26.88 +/- 28.27 mg/ dl in CD patients and disease control group respectively and the difference in the level of serum IgA between these groups was not statistically significant [p=0.75]. Mean IgA level in sub-group -I and sub-group- II was 40.85 +/- 33.29 mg/dl and 32.92 +/- 24.85 mg/dl respectively and the difference in the level of serum IgA between these sub-groups was not statistically significant [p = 0.47]. In Group - A, mean level of IgA in males and females was 42.38 +/- 38.02 mg/dl and 34.41 +/- 20.36 mg/dl respectively and the difference in the level of IgA level was not statistically significant between these groups [p = 0.41]. Selective IgA deficiency [SIgAD] was found in CD and in patients of other gastrointestinal complaints. In order to detect CD in SIgAD, total serum IgA level should also be performed with IgG - antigliadin or IgG-anti-tTG antibodies