Wengrower Dov, Doron Dafna, Goldin Eran, Granot Esther
Institute of Gastroenterology, Hadassah University, Hospital, Jerusalem, Israel.
J Clin Gastroenterol. 2006 Oct;40(9):806-8. doi: 10.1097/01.mcg.0000225605.18234.e3.
Tissue transglutaminase (tTG) antibodies are currently recognized as a highly sensitive indicator of celiac disease (CD). Although a high concordance rate between tTG antibodies and anti-endomysial antibodies (EMA) has been reported up to a third of known CD patients are positive for only one of these antibodies.
To determine whether in laboratories in which serum samples previously examined for CD serology markers had not been discarded, these samples should be tested for tTG antibodies.
Fifty-eight stored (frozen at -70) serum samples of patients previously found to be EMA-negative but positive for one or more of the non-EMA markers: antigliadin antibodies (AGA)-IgA, AGA-IgG, antireticulin antibodies, were tested for anti-tTG antibodies (IMMCO Diagnostics). In patients found to be tTG positive, medical charts were reviewed and patients or their physicians contacted.
Twelve of fifty-eight (20.7%) samples were found to be anti-tTG positive. These included: group A: 3/3 samples previously positive for AGA-IgA, AGA-IgG, and antireticulin antibodies. Group B: 3/16 samples positive for AGA-IgA and AGA-IgG. Group C: 3/4 samples positive for AGA-IgA and group D: 3/35 samples positive for AGA-IgG. Of the 12 positive patients, 1 was a 2-year-old boy, 5 were lost to follow up, and 7 underwent an intestinal biopsy. In 3 of these 7 patients, the biopsy was compatible with CD; 2 of these 3 patients were from group A and 1 from group B.
In laboratories where stored serum samples are available, EMA-negative samples previously found to be positive for at least 2 other CD markers should be retested for tTG antibodies.
组织转谷氨酰胺酶（tTG）抗体目前被认为是乳糜泻（CD）的一种高度敏感指标。尽管据报道tTG抗体与抗肌内膜抗体（EMA）之间的一致性率很高，但已知三分之一的CD患者仅对其中一种抗体呈阳性。
确定在那些之前检测过CD血清学标志物的血清样本尚未丢弃的实验室中，是否应对这些样本进行tTG抗体检测。
对58份储存（-70℃冷冻）的患者血清样本进行抗tTG抗体检测（IMMCO诊断公司），这些患者之前被发现EMA阴性，但对一种或多种非EMA标志物呈阳性：抗麦醇溶蛋白抗体（AGA）-IgA、AGA-IgG、抗网硬蛋白抗体。对于tTG呈阳性的患者，查阅病历并联系患者或其医生。
58份样本中有12份（20.7%）抗tTG呈阳性。其中包括：A组：3/3份样本之前AGA-IgA、AGA-IgG和抗网硬蛋白抗体呈阳性。B组：16份样本中有3份AGA-IgA和AGA-IgG呈阳性。C组：4份样本中有3份AGA-IgA呈阳性，D组：35份样本中有3份AGA-IgG呈阳性。在这12名阳性患者中，1名是2岁男孩，5名失访，7名接受了肠道活检。在这7名患者中的3名，活检结果符合CD；这3名患者中有2名来自A组，1名来自B组。
在有储存血清样本的实验室中，之前发现EMA阴性且至少对其他2种CD标志物呈阳性的样本应重新检测tTG抗体。
