Pediatric Nutrition

Diagnostic significance of endomysial and tissue transglutaminase antibodies for diagnosing celiac disease and other gastrointestinal diseases

The objective. To determine insufficient specificity of tissue transglutaminase (tTG) and endomysial (EMA) auto-antibodies by the example of inflammatory bowel diseases (IBD) and to establish their diagnostic value. Patients  and  methods.  The  examination  included  patients  with  Crohn’s  disease  (n  =  39),  ulcerative  colitis  (n  =  52),  celiac disease (n = 33), and the reference group (n = 63). The median age was 26.7 ± 12.8 years. The methods of enzyme-linked immunoassay (tTG) and indirect immunofluorescence (ЕМА) were used. Results. Enhanced values of IgА-tTG (n = 4) and IgG-tTG (n = 62) were obtained in the group of patients with IBD. A relation between  IgG-tTG  and  the  severity  of  damage  of  the  intestinal  wall  was  found,  confirmed  by  Spearman’s  rank  correlation coefficient (rs 0.73, р <- 0.01). Positive values of tTG were recorded in the reference group (n = 9). Titres of EMA in all patients with IBD and in the reference group did not exceed the reference limits. Sensitivity of EMA and tTG, which was not appropriate for diagnosing atypical celiac disease, was determined. Conclusion. Insufficient specificity of tTG was proven- IgG-тТГ was determined as a marker for the severity of damage of the intestinal wall in patients with IBD. The diagnostic algorithm for differential diagnosis of IBD, along with other markers, should include detection of EMA. Insufficient sensitivity of EMA and tTG was determined.