Endomysial antibodies predict celiac disease irrespective of the titers or clinical presentation.

Abstract

AIM:

To investigate the association between serum antibody levels and a subsequent celiac disease diagnosis in a large series of children and adults.

METHODS:

Besides subjects with classical gastrointestinal presentation of celiac disease, the study cohort included a substantial number of individuals with extraintestinal symptoms and those found by screening in at-risk groups. Altogether 405 patients underwent clinical, serological and histological evaluations. After collection of data, the antibody values were further graded as low [endomysial (EmA) 1:5-200, transglutaminase 2 antibodies (TG2-ab) 5.0-30.0 U/L] and high (EmA 1: ≥ 500, TG2-ab ≥ 30.0 U/L), and the serological results were compared with the small intestinal mucosal histology and clinical presentation.

RESULTS:

In total, 79% of the subjects with low and 94% of those with high serum EmA titers showed small-bowel mucosal villous atrophy. Furthermore, 96% of the 47 EmA positive subjects who had normal mucosal villi and remained on follow-up either subsequently developed mucosal atrophy while on a gluten-containing diet, or responded positively to a gluten-free diet.

CONCLUSION:

Irrespective of the initial serum titers or clinical presentation, EmA positivity as such is a very strong predictor of a subsequent celiac disease diagnosis.

• Authors: Kalle Kurppa, Tiia Räsänen, Pekka Collin, Sari Iltanen, Heini Huhtala, Merja Ashorn, Päivi Saavalainen, Katri Haimila, Jukka Partanen, Markku Mäki, Katri Kaukinen
• Journal: World journal of gastroenterology (World J Gastroenterol) Vol. 18 Issue 20 Pg. 2511-6 (May 28 2012) ISSN: 2219-2840 [Electronic] United States
• PMID: 22654448 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Autoantibodies
• Immunoglobulin A
• Protein Glutamine gamma Glutamyltransferase 2
• Transglutaminases
• GTP-Binding Proteins

Topics

• Adolescent
• Adult
• Aged
• Autoantibodies (blood)
• Celiac Disease (blood, diagnosis, pathology)
• Child
• Child, Preschool
• Connective Tissue (immunology)
• Female
• GTP-Binding Proteins (immunology)
• Humans
• Immunoglobulin A (blood)
• Infant
• Intestinal Mucosa (immunology)
• Intestine, Small (immunology)
• Male
• Middle Aged
• Muscle, Smooth (immunology)
• Protein Glutamine gamma Glutamyltransferase 2
• Transglutaminases (immunology)
• Young Adult