Ortiz Gonzalo, Messere Gabriela, Toca María Del C, Fiorucci Mirian, Bigliardi Román, Vidal Jorge, Reynoso Ricardo
Sección de Gastroenterología, Hepatología y Nutrición Infantil, Servicio de Pediatría.
Servicio de Laboratorio. Hospital Nacional Alejandro Posadas.
Arch Argent Pediatr. 2019 Feb 1;117(1):52-55. doi: 10.5546/aap.2019.eng.52.
To compare the performance of IgA anti-tissue transglutaminase antibodies (IgA anti-tTG), IgA anti-endomysial antibodies (IgA EMA), and IgA/IgG antibodies against deamidated gliadin peptides (IgA/IgG anti-DGP) for the diagnosis of celiac disease.
Descriptive study in patients with celiac disease. Anti-DGP (IgA/IgG), IgA EMA, IgA anti-tTG antibodies were measured and an intestinal biopsy was done. Sex: female (61 %). Median age: 78.4 months old.
A total of 136 children were included; 108 had high IgA anti-DGP titers; 124, increased IgG anti-DGP titers; 128, positive IgA EMA titers; and 130, increased IgA anti-tTG titers. High IgG anti-DGP titers were observed in 4/6 patients with negative IgA anti-tTG antibodies. The combination of IgG anti-DGP + IgA anti-tTG antibodies showed a positive correlation in 134 patients and the IgG anti-DGP + EMA combination was positive in 133 children.
IgA EMA, IgA anti-tTG, and IgG anti-DGP antibodies exhibited an adequate specificity and sensitivity. The IgG anti-DGP/anti-tTG combination showed a 98-99 % sensitivity and a 100 % specificity. The anti-tTG and IgG anti-DGP option yields excellent results, with a low cost and independence from the observer.
比较抗组织转谷氨酰胺酶IgA抗体（IgA抗tTG）、抗肌内膜IgA抗体（IgA EMA）和抗脱酰胺麦醇溶蛋白肽IgA/IgG抗体（IgA/IgG抗DGP）在乳糜泻诊断中的性能。
对乳糜泻患者进行描述性研究。检测抗DGP（IgA/IgG）、IgA EMA、IgA抗tTG抗体，并进行肠道活检。性别：女性（61%）。中位年龄：78.4个月。
共纳入136名儿童；108名IgA抗DGP滴度高；124名IgG抗DGP滴度升高；128名IgA EMA滴度阳性；130名IgA抗tTG滴度升高。在6名IgA抗tTG抗体阴性的患者中有4名观察到高IgG抗DGP滴度。IgG抗DGP + IgA抗tTG抗体组合在134名患者中呈正相关，IgG抗DGP + EMA组合在133名儿童中呈阳性。
IgA EMA、IgA抗tTG和IgG抗DGP抗体表现出足够的特异性和敏感性。IgG抗DGP/抗tTG组合显示出98 - 99%的敏感性和100%的特异性。抗tTG和IgG抗DGP组合产生了优异的结果，成本低且不受观察者影响。
