Serum IgA tissue transglutaminase antibodies in coeliac disease and other gastrointestinal diseases

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Abstract
We investigated the presence of IgA anti‐tissue transglutaminase (tTG) antibodies in untreated coeliac disease (CD) and other gastrointestinal diseases, and compared IgA tTG concentrations with anti‐endomysium (EMA) immunofluorescent findings. The study included 116 untreated CD patients (74 female, 42 male, age range 15–78 years, median 47 years), 82 treated CD patients, 65 patients with normal duodenal histology, 260 disease control samples and 29 healthy volunteers. IgA anti‐tTG, EMA, and anti‐gliadin (AGA) antibodies were measured. Serum total IgA was measured in the CD patients. Two IgA‐deficient untreated CD patients were excluded. IgA EMA and IgA AGA were positive in 99 (87%) and 69 (61%), respectively, of the 114 untreated CD patients. Elevated IgA anti‐tTG were found in 92/114 (81%) untreated coeliacs, 1/82 (1%) treated coeliacs, 2/65 (3%) non‐coeliacs, 10/260 (4%) disease controls and 2/29 (7%) volunteers. Four of the untreated CD patients, with a normal serum total IgA concentration, were negative for all the serological tests. IgA anti‐tTG concentrations were significantly higher in untreated coeliacs (median 10200 units/ml) than in other groups (Mann–Whitney, p2=0.54; p<0.0001).

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