儿童乳糜泻中抗组织转谷氨酰胺酶 IgA 的肠内沉积。
Intestinal deposits of anti-tissue transglutaminase IgA in childhood celiac disease.
机构信息
Department of Pediatrics and European Laboratory for the Investigation of Food-Induced Diseases, University "Federico II", Naples, Italy.
出版信息
Dig Liver Dis. 2011 Aug;43(8):604-8. doi: 10.1016/j.dld.2011.01.015. Epub 2011 Feb 20.
BACKGROUND
High serum levels of anti-tissue-transglutaminase-2 IgA antibodies (anti-TG2), which are produced and deposited in the intestine, characterize celiac disease.
AIM
To assess the diagnostic value of intestinal deposits of anti-TG2 IgA for celiac disease in a paediatric population.
METHODS
344 children underwent duodenal biopsy for the suspicion of CD, and were divided into 3 groups: group A, 144 celiac subjects with villous atrophy (Marsh 3b-c); group B, 109 subjects with high serum levels of anti-TG2 but normal intestinal mucosa (Marsh 0-1) (potential celiac disease patients); group C, 91 subjects with normal levels of serum anti-TG2: 70 with Marsh 0-1 and 21 with Marsh 3a mucosa. All duodenal sections were evaluated for the presence of intestinal deposits of anti-TG2 IgA by double immunofluorescence.
RESULTS
Deposits of anti-TG2 IgA were present in 96%, 68%, 12% of patients from groups A, B, C, respectively. Diagnostic sensitivity and specificity for celiac disease were 96% and 88% vs. 97% and 100% for serum anti-TG2, respectively. The degree of concordance with serum anti-TG2 was 85%.
CONCLUSION
Detection of intestinal deposits of anti-TG2 IgA is a useful diagnostic tool. Further research is needed regarding their ability to predict evolution to villous atrophy in potential celiac disease.
背景
抗组织转谷氨酰胺酶 2 IgA 抗体（抗 TG2）的血清水平升高，这种抗体在肠道中产生并沉积，是乳糜泻的特征。
目的
评估肠道抗 TG2 IgA 沉积对儿科人群乳糜泻的诊断价值。
方法
344 名儿童因疑似 CD 而行十二指肠活检，并分为 3 组：A 组，144 例乳糜泻患者有绒毛萎缩（Marsh 3b-c）；B 组，109 例抗 TG2 血清水平高但肠道黏膜正常（Marsh 0-1）（潜在乳糜泻患者）；C 组，91 例抗 TG2 血清水平正常：70 例 Marsh 0-1，21 例 Marsh 3a 黏膜。所有十二指肠切片均通过双免疫荧光法评估肠道抗 TG2 IgA 沉积情况。
结果
A、B、C 组患者的抗 TG2 IgA 沉积率分别为 96%、68%、12%。乳糜泻的诊断敏感性和特异性分别为 96%和 88%，与血清抗 TG2 相比分别为 97%和 100%。与血清抗 TG2 的一致性程度为 85%。
结论
检测肠道抗 TG2 IgA 沉积是一种有用的诊断工具。需要进一步研究其在预测潜在乳糜泻患者绒毛萎缩方面的能力。
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