IgA class anti-endomysial and anti-tissue transglutaminase antibodies in relation to duodenal mucosa changes in coeliac disease.

AIM

The aim of the present study was to correlate the serological methods of coeliac disease diagnostic tests (IgA EmA and IgA anti-tTG) with the histological findings of the duodenal mucosa.

METHODS AND RESULTS

Forty-seven patients were studied and the data were analysed by the Pearson correlation. Seven patients (15%) with normal mucosa were negative for both assays. Forty untreated patients showed 89% agreement between the two serological methods, with all samples (40/40) positive to EmA and 80% (32/40) positive to anti-tTG. Eight positive samples to EmA, that were negative to anti-tTG, presented an increased number of intra-epithelial lymphocytes in the duodenal biopsy and clinical improvement with a gluten-free diet. Partial or total villous atrophy was detected with EmA titres equal to or higher than 1/10. The correlation coefficient between the two serological methods was R=0.797.

CONCLUSIONS

Both serological tests correlated very well with histological findings in negative patients and in those with high levels of antibodies. For patients with clinical evidence of CD but with low levels of antibodies, the combination of serological tests and intestinal biopsy is recommended.