6533b824fe1ef96bd1280a8b
RESEARCH PRODUCT
Antiendomysium antibodies assay in the culture medium of intestinal mucosa: an accurate method for celiac disease diagnosis
Ada Maria FlorenaLidia Di PrimaGiuseppe PirroneAntonio CarroccioPasquale MansuetoGaetana Di FedeSaverio TeresiGiuseppe AmbrosianoCarmelo SciumèMaurizio SoresiFranco BarbariaGiuseppina CampisiIlenia PepeFrancesca CavataioGiuseppe IaconoGirolamo Geracisubject
AdultMalemedicine.medical_specialtyPathologySettore MED/09 - Medicina InternaAdolescentTissue transglutaminaseDuodenumBiopsyMuscle Fibers Skeletalceliac disease culture system diagnosis intestinal histology serum antiendomysiumDiseaseHuman leukocyte antigenGastroenterologyAntiendomysium antibodiesTissue Culture TechniquesYoung AdultIntestinal mucosaInternal medicineBiopsyMedicineHumansVillous atrophyIntestinal MucosaChildFalse Negative ReactionsAgedAutoantibodiesTransglutaminasesHepatologybiologymedicine.diagnostic_testbusiness.industryGastroenterologyInfantMiddle AgedCulture MediaCeliac DiseaseChild Preschoolbiology.proteinFemaleAntibodybusinessEpidemiologic MethodsBiomarkersdescription
Background Celiac disease (CD) diagnosis is becoming more difficult as patients with no intestinal histology lesions may also be suffering from CD. Aim To evaluate the diagnostic accuracy of antiendomysium (EmA) assay in the culture medium of intestinal biopsies for CD diagnosis. Patients and methods The clinical charts of 418 patients with CD and 705 non-CD controls who had all undergone EmA assay in the culture medium were reviewed. Results EmA assay in the culture medium had a higher sensitivity (98 vs. 80%) and specificity (99 vs. 95%) than serum EmA/antibodies to tissue transglutaminase (anti-tTG) assay. All patients with CD who were tested as false-negatives for serum EmA and/or anti-tTG (32 adults and 39 children) carried the human leukocyte antigen alleles associated to CD. Furthermore, during the follow-up, four patients with negative-serum EmA/anti-tTG, normal villi architecture, and positive-EmAs in the culture medium, developed villous atrophy and underwent gluten-free diet with consequent resolution of the symptoms and complete intestinal histology recovery. Conclusion EmA assay in the culture medium should be included in the diagnostic criteria for CD diagnosis in 'seronegative' patients. Eur J Gastroenterol Hepatol 23:1018-1023 (C) 2011 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2011-01-01 |