Determinación de anticuerpos anti-transglutaminasa en el diagnóstico de enfermedad celíaca / Antitransglutaminase antibodies for the diagnosis of celiac disease

RESUMO

Background: The diagnosis of celiac disease is based in clinical features, serology and intestinal biopsy. There are recent reports that antiglutaminase antibodies have a good correlation with anti endomisial antibodies. Aim: To assess the sensitivity and specificity of antitransglutaminase antibodies in the diagnosis of celiac disease and their correlation with antiendomisial antibodies. Material and methods: Forty nine patients with celiac disease (mean age 30 years, 12 male) were studied. Thirty were symptomatic and 19, asymptomatic. As controls, 34 subjects (mean age 27 years, seven male), with normal duodenal biopsies, were studied. Sera was processed for the determination of antigliadin IgA by ELISA, antiendomisium IgA by indirect immunofluorescence, and antitransglutaminase IgA by ELISA. Results: Antigliadin antibodies had a sensitivity of 73 percent, a specificity of 96 percent, a positive predictive value of 93 percent and a negative predictive value of 82 percent for the diagnosis of celiac disease. Antiendomisium and antitransglutaminase antibodies had a specificity and positive predictive value of 100 percent, sensitivities of 89 and 92 percent respectively and negative predictive values of 92 and 94 percent respectively. No significant differences in the diagnostic yield of antiendomisium and antitransglutaminase antibodies, were observed. Conclusions: In this group of patients, antitransglutaminase antibodies had a high concordance with antiendomisium antibodies, for the diagnosis of celiac disease. Considering that the determination of antitransglutaminase antibodies is of lower cost and less complicated than antiendomisium antibodies, it is a useful tool for the diagnosis and follow up of patients with celiac disease