Department of Clinical-Surgical, Diagnostic and Pediatric Science, Institute of Dermatology, University of Pavia, Pavia, Italy.
J Eur Acad Dermatol Venereol. 2013 Jul;27(7):836-41. doi: 10.1111/j.1468-3083.2012.04586.x. Epub 2012 Jun 2.
Dermatitis herpetiformis (DH) is a rare gluten-sensitive blistering itchy skin disease, strictly related to coeliac disease (CD). Direct immunofluorescence, demonstrating IgA granular deposits localized either in the dermal papillae or along the dermo-epidermal junction, is currently the gold standard for diagnosis of DH. It has been shown that DH immunocomplexes contain epidermal transglutaminase (eTG) and that sera from patients with DH contain antibodies specifically directed against eTG.
We studied the usefulness of serum eTG antibodies in discriminating between DH, CD and other gastrointestinal and dermatologic diseases.
eTG antibodies were tested in 308 adult patients' sera: 44 patients with untreated dermatitis herpetiformis (UDH), 99 patients with untreated coeliac disease (UCD), 70 dermatological controls and 95 gastrointestinal controls.
In UDH eTG antibody levels were significantly higher than in DH patients on gluten-free diet, UCD, gastrointestinal controls and dermatological controls. In UCD eTG antibodies strongly correlated with tissue transglutaminase (tTG) antibodies, whereas in UDH no significant correlation was observed.
Serum IgA eTG antibody determination can efficiently distinguish UDH from other dermatological itchy diseases and is highly sensitive to gluten-free diet.
疱疹样皮炎（DH）是一种罕见的麸质敏感的水疱性瘙痒性皮肤病，与乳糜泻（CD）密切相关。直接免疫荧光法显示 IgA 颗粒状沉积物定位于真皮乳头或沿表皮真皮交界处，目前是 DH 诊断的金标准。已经表明 DH 免疫复合物含有表皮转谷氨酰胺酶（eTG），并且来自 DH 患者的血清含有针对 eTG 的特异性抗体。
我们研究了血清 eTG 抗体在区分 DH、CD 和其他胃肠道和皮肤病方面的有用性。
在 308 名成年患者的血清中检测了 eTG 抗体：44 名未经治疗的疱疹样皮炎（UDH）患者，99 名未经治疗的乳糜泻（UCD）患者，70 名皮肤科对照患者和 95 名胃肠道对照患者。
UDH 患者的 eTG 抗体水平明显高于无麸质饮食、CD、胃肠道对照和皮肤科对照的 DH 患者。在 UCD 中，eTG 抗体与组织转谷氨酰胺酶（tTG）抗体强烈相关，而在 UDH 中未观察到明显相关性。
血清 IgA eTG 抗体测定可有效区分 UDH 与其他瘙痒性皮肤病，对无麸质饮食高度敏感。
