Celiac disease and immunoglobulin a deficiency: how effective are the serological methods of diagnosis?

Celiac disease and immunoglobulin a deficiency: how effective are the serological methods of diagnosis?

Immunoglobulin A (IgA) deficiency is 10 to 15 times more common in patients with celiac disease (CD) than in healthy subjects. Serological tests have become the preferred methods of diagnosing CD in both symptomatic and asymptomatic patients. However, commercially available serological methods are l...

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Bibliographic Details
Published in:Clinical and diagnostic laboratory immunology Vol. 9; no. 6; pp. 1295 - 1300
Main Authors: Kumar, V, Jarzabek-Chorzelska, M, Sulej, J, Karnewska, Krystyna, Farrell, T, Jablonska, S
Format: Journal Article
Language:English
Published: United States American Society for Microbiology 01-11-2002
Subjects:
Adolescent
Autoantibodies - blood
Celiac Disease - diagnosis
Celiac Disease - immunology
Child
Child, Preschool
Gliadin - immunology
GTP-Binding Proteins - immunology
Humans
IgA Deficiency - diagnosis
Immune-Mediated Responses and Disorders
Immunoglobulin A - blood
Immunoglobulin G - blood
Infant
Serologic Tests - methods
Transglutaminases - immunology
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Summary:Immunoglobulin A (IgA) deficiency is 10 to 15 times more common in patients with celiac disease (CD) than in healthy subjects. Serological tests have become the preferred methods of diagnosing CD in both symptomatic and asymptomatic patients. However, commercially available serological methods are limited in that they detect only the IgA isotype of antibodies (with the exception of IgG gliadin assays); hence, IgA-deficient patients with CD may yield false-negative serology. Fifteen pediatric patients with CD and 10 IgA-deficient pediatric patients without CD were examined for IgA and IgG antibodies to endomysium, gliadin, and tissue transglutaminase. Twenty-five specimens from patients with IgA deficiency were examined. Fifteen were from patients with CD, and 10 were patients without CD. All 15 IgA-deficient patients with CD were positive for endomysium antibodies of the IgG isotype and for IgG gliadin antibodies. All but one of the IgA-deficient patients with CD were also positive for IgG tissue transglutaminase antibodies. None of the IgA-deficient patients without CD were positive for any of the antibody markers. All the specimens examined were also negative for IgA-specific antibodies to endomysium, gliadin, and tissue transglutaminase. IgG-specific antibody tests for endomysium, gliadin, and tissue transglutaminase are useful for the identification of IgA-deficient patients with CD. IgG antibody tests along with tests routinely being used in clinical laboratories can reliably detect all active patients with CD. In addition, the levels of these CD-specific IgG antibodies could be used to monitor patient dietary compliance.
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Corresponding author. Mailing address: IMMCO Diagnostics, Inc., 60 Pineview Dr., Buffalo, NY 14228. Phone: (716) 691-0091. Fax: (716) 691-0466. E-mail: Vkumar@immcodiagnostics.com.
ISSN:1071-412X
1098-6588
DOI:10.1128/CDLI.9.6.1295-1300.2002