role of anti-tissue transglutaminase IgA for the diagnosis of celiac disease

ABSTRACT

To evaluate and compare the sensitivity and specificity of the serological marker human antitissue transglutarninase antibodies [IgA anti-tTG] with those of antiendomysium [EMA] and antigliadin antibodies [IgA and lgG AGA] for the diagnosis of celiac disease [CD]. The level of IgA antibodies to tTG in serum was determined by an enzyme-linked immunosorbent assay [ELISA] test using recombinant human tTG as the antigen; EMA, by indirect immunofluorescence; and IgA and IgG AGA, by ELISA. Twenty serum samples with untreated CD were studied and compared with serum samples from 58 children examined for failure to thrive, short stature and various digestive diseases as control group. Nineteen of 20 patients with CD had IgA anti-tTG, 20 of 20 patients had EMA, 16 of 20 had IgA AGA and 19 of 20 had lgG AGA. In control group without CD, 2 Of 58 had IgA AGA and 12 of 58 had lgG AGA, but none had IgA anti-tTG or EMA. The positive predictive value of IgA anti-tTG was 100% and the negative predictive value 98.3%. In comparison, results for EMA were 100% and 100%, IgA AGA 88.9% and93.3%and IgG AGA 61.3% and 97.9% respectively. The presence of human anti-tTG is a reliable indicator for the diagnosis of CD