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Tissue transglutaminase immunoglobulin isotypes in children with untreated and treated celiac disease

Agardh, Daniel LU ; Borulf, Stefan LU ; Lernmark, Åke LU orcid and Ivarsson, Sten LU (2003) In Journal of Pediatric Gastroenterology and Nutrition - Jpgn 36(1). p.77-82
Abstract
Objectives: Tissue transglutaminase (tTG) autoantibodies are serologic markers for celiac disease (CD). The aim was to determine the diagnostic sensitivity and specificity of different immunoglobulin isotypes against tTG. Methods: Immunoglobulin A (IgA)-tTG, IgG-tTG, and IgGl-tTG were measured in radioligand binding assays in 67 children with untreated and 89 children with treated CD and compared with 48 biopsy controls. IgM-tTG was measured in children with untreated CD and in biopsy controls. IgA endomysial autoantibodies (EMA) were analyzed in all children using an immunofluorescence method. Results: The sensitivity of IgA-tTG and IgG-tTG was 85.1% (57 of 67) and 83.6% (56 of 67), respectively, which both increased to 93.8% (45 of 48)... (More)
Objectives: Tissue transglutaminase (tTG) autoantibodies are serologic markers for celiac disease (CD). The aim was to determine the diagnostic sensitivity and specificity of different immunoglobulin isotypes against tTG. Methods: Immunoglobulin A (IgA)-tTG, IgG-tTG, and IgGl-tTG were measured in radioligand binding assays in 67 children with untreated and 89 children with treated CD and compared with 48 biopsy controls. IgM-tTG was measured in children with untreated CD and in biopsy controls. IgA endomysial autoantibodies (EMA) were analyzed in all children using an immunofluorescence method. Results: The sensitivity of IgA-tTG and IgG-tTG was 85.1% (57 of 67) and 83.6% (56 of 67), respectively, which both increased to 93.8% (45 of 48) in children diagnosed at age 2 years or older. Both had a specificity of 93.8% (45 of 48). IgA-EMA had a sensitivity of 80.6% (54 of 67) and a specificity of 91.7% (44 of 48). In treated CD, IgA-tTG and IgG-tTG were detected in 21.3% (19 of 89) and in 14.6% (13 of 89), respectively, despite negative EMA titers. IgGl-tTG was correlated to age (r = -0.47, P = 0.0005) and detected in 50.7% (34 of 67) with untreated CD compared with 11.2% (10 of 89) with treated CD and with 4.2% (2 of 48) of biopsy controls (P < 0.0001, respectively). IgM-tTG was detected in 1.5% (1 of 67) with untreated CD and in none of biopsy controls. Conclusion: IgA-tTG and IgG-tTG analyzed in radioligand binding assays are equivalent to IgA-EMA as screening tests for CD during childhood, but an intestinal biopsy is still the method of choice to establish the diagnosis. Although IgGl-tTG was more common at young age of diagnosis, both IgGl-tTG and IgM-tTG had low specificity and sensitivity and may not be useful as screening tests for CD. (Less)
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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
tTG autoantibodies, celiac disease, EMA
in
Journal of Pediatric Gastroenterology and Nutrition - Jpgn
volume
36
issue
1
pages
77 - 82
publisher
Lippincott Williams & Wilkins
external identifiers
  • pmid:12500000
  • wos:000180143400014
  • scopus:0344952228
ISSN
1536-4801
language
English
LU publication?
yes
additional info
The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Diabetes and Celiac Unit (013241540), Pediatrics/Urology/Gynecology/Endocrinology (013240400), Paediatric Endocrinology Research Group (013243010)
id
0d20571b-42a9-4dd1-9e4e-1b4cc5483668 (old id 320623)
alternative location
http://jpgn.org
date added to LUP
2016-04-01 12:24:31
date last changed
2022-01-27 03:21:53
@article{0d20571b-42a9-4dd1-9e4e-1b4cc5483668,
  abstract     = {{Objectives: Tissue transglutaminase (tTG) autoantibodies are serologic markers for celiac disease (CD). The aim was to determine the diagnostic sensitivity and specificity of different immunoglobulin isotypes against tTG. Methods: Immunoglobulin A (IgA)-tTG, IgG-tTG, and IgGl-tTG were measured in radioligand binding assays in 67 children with untreated and 89 children with treated CD and compared with 48 biopsy controls. IgM-tTG was measured in children with untreated CD and in biopsy controls. IgA endomysial autoantibodies (EMA) were analyzed in all children using an immunofluorescence method. Results: The sensitivity of IgA-tTG and IgG-tTG was 85.1% (57 of 67) and 83.6% (56 of 67), respectively, which both increased to 93.8% (45 of 48) in children diagnosed at age 2 years or older. Both had a specificity of 93.8% (45 of 48). IgA-EMA had a sensitivity of 80.6% (54 of 67) and a specificity of 91.7% (44 of 48). In treated CD, IgA-tTG and IgG-tTG were detected in 21.3% (19 of 89) and in 14.6% (13 of 89), respectively, despite negative EMA titers. IgGl-tTG was correlated to age (r = -0.47, P = 0.0005) and detected in 50.7% (34 of 67) with untreated CD compared with 11.2% (10 of 89) with treated CD and with 4.2% (2 of 48) of biopsy controls (P &lt; 0.0001, respectively). IgM-tTG was detected in 1.5% (1 of 67) with untreated CD and in none of biopsy controls. Conclusion: IgA-tTG and IgG-tTG analyzed in radioligand binding assays are equivalent to IgA-EMA as screening tests for CD during childhood, but an intestinal biopsy is still the method of choice to establish the diagnosis. Although IgGl-tTG was more common at young age of diagnosis, both IgGl-tTG and IgM-tTG had low specificity and sensitivity and may not be useful as screening tests for CD.}},
  author       = {{Agardh, Daniel and Borulf, Stefan and Lernmark, Åke and Ivarsson, Sten}},
  issn         = {{1536-4801}},
  keywords     = {{tTG autoantibodies; celiac disease; EMA}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{77--82}},
  publisher    = {{Lippincott Williams & Wilkins}},
  series       = {{Journal of Pediatric Gastroenterology and Nutrition - Jpgn}},
  title        = {{Tissue transglutaminase immunoglobulin isotypes in children with untreated and treated celiac disease}},
  url          = {{http://jpgn.org}},
  volume       = {{36}},
  year         = {{2003}},
}