IgA anti-tissue transglutaminase antibodies and IgG antibodies against deamidated gliadin peptides as predictors of celiac disease

Arch Argent Pediatr. 2019 Feb 1;117(1):52-55. doi: 10.5546/aap.2019.eng.52.
[Article in English, Spanish]

Abstract
in English, Spanish

Objective: To compare the performance of IgA anti-tissue transglutaminase antibodies (IgA anti-tTG), IgA anti-endomysial antibodies (IgA EMA), and IgA/IgG antibodies against deamidated gliadin peptides (IgA/IgG anti-DGP) for the diagnosis of celiac disease.

Methods: Descriptive study in patients with celiac disease. Anti-DGP (IgA/IgG), IgA EMA, IgA anti-tTG antibodies were measured and an intestinal biopsy was done. Sex: female (61 %). Median age: 78.4 months old.

Results: A total of 136 children were included; 108 had high IgA anti-DGP titers; 124, increased IgG anti-DGP titers; 128, positive IgA EMA titers; and 130, increased IgA anti-tTG titers. High IgG anti-DGP titers were observed in 4/6 patients with negative IgA anti-tTG antibodies. The combination of IgG anti-DGP + IgA anti-tTG antibodies showed a positive correlation in 134 patients and the IgG anti-DGP + EMA combination was positive in 133 children.

Conclusion: IgA EMA, IgA anti-tTG, and IgG anti-DGP antibodies exhibited an adequate specificity and sensitivity. The IgG anti-DGP/anti-tTG combination showed a 98-99 % sensitivity and a 100 % specificity. The anti-tTG and IgG anti-DGP option yields excellent results, with a low cost and independence from the observer.

Objetivo. Comparar el rendimiento de anticuerpos antitransglutaminasa IgA (anti-TG2 IgA), antiendomisio IgA (EMA IgA) y antigliadina desaminada IgA/IgG (AGADGP IgA/IgG) para el diagnóstico de enfermedad celiaca. Métodos. Estudio descriptivo en pacientes con enfermedad celíaca. Se dosaron anticuerpos: AGADGP (IgA/IgG), EMA IgA, anti-TG2 IgA y biopsia intestinal. Sexo: mujeres (61 %). Mediana de edad: 78,4 meses. Resultados. Se incluyeron 136 niños; 108 presentaron AGADGP IgA elevado; 124, AGADGP IgG aumentado; 128, EMA IgA positivo; 130, anti-TG2 IgA aumentado. Cuatro de 6 pacientes con anti-TG2 IgA negativos tenían AGADGP IgG elevado. La combinación de los anticuerpos AGADGP IgG + anti-TG2 IgA tuvo una correlación positiva en 134 pacientes y la combinación AGADGP IgG + EMA fue positiva en 133 niños. Conclusión. Se demostró la buena especificidad y sensibilidad de EMA IgA, anti-TG2 IgA y AGADGP IgG. La combinación AGADGP IgG/anti-TG2 mostró sensibilidad del 98-99 % y especificidad del 100 %. La elección de anti-TG2 y AGADGP IgG da excelentes resultados, con bajo costo y no depende del operador.

Keywords: Antibodies; Celiac disease; Children; Diagnosis.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Autoantibodies / blood*
  • Celiac Disease / diagnosis*
  • Celiac Disease / immunology*
  • Child
  • Female
  • GTP-Binding Proteins / immunology*
  • Gliadin / immunology*
  • Humans
  • Immunoglobulin A / blood*
  • Immunoglobulin G / blood*
  • Male
  • Predictive Value of Tests
  • Protein Glutamine gamma Glutamyltransferase 2
  • Transglutaminases / immunology*

Substances

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