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Selective measurement of anti-tTG antibodies in coeliac disease and IgA deficiency : an alternative pathway
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Harrison, Elizabeth, Liu, Kuo-Kang, Petchey, Michael, Nwokolo, Chuka U., Loft, Duncan and Arasaradnam, Ramesh P.. (2013) Selective measurement of anti-tTG antibodies in coeliac disease and IgA deficiency : an alternative pathway. Postgraduate Medical Journal, Volume 89 (Number 1047). pp. 4-7. ISSN 0032-5473
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Official URL: http://dx.doi.org/10.1136/postgradmedj-2011-130188
Abstract
Objective
To determine the ability of selective antibody testing to screen for coeliac disease in
the presence of IgA deficiency and to define the sensitivity of a pathway using this
method (Figure1).
Method
All IgA and IgG anti-tTG tests performed at our centre between January 2008 and
December 2009, using the Immunocap 250 analyser, were retrospectively reviewed.
Positive results were correlated with histology. Results were used to validate our
diagnostic pathway.
Results
12,289 consecutive serological tests were reviewed. IgA deficient patients gave either
an “error” reading or very low response on the Immunocap 250 analyser. Subsequent
testing of this sub-group demonstrated raised IgG anti-tTG antibodies in those with
histologically proven coeliac disease.
Conclusions
Using our antibody screening pathway, which involves the selective use of IgG antitTG,
sensitivity increased from 87% to 92% in those with IgA deficiency. Adoption
of this pathway for coeliac screening would negate the routine screening of
immunoglobulin levels, with resultant cost saving.
| Item Type: | Journal Article |
|---|---|
| Subjects: | Q Science > QP Physiology R Medicine > RC Internal medicine |
| Divisions: | Faculty of Medicine > Warwick Medical School > Clinical Sciences Research Institute (CSRI) Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School > Metabolic and Vascular Health |
| Library of Congress Subject Headings (LCSH): | Celiac disease -- Diagnosis, Immunoglobulin A, Immunoglobulin G |
| Journal or Publication Title: | Postgraduate Medical Journal |
| Publisher: | BMJ |
| ISSN: | 0032-5473 |
| Official Date: | August 2013 |
| Volume: | Volume 89 |
| Number: | Number 1047 |
| Page Range: | pp. 4-7 |
| Identification Number: | 10.1136/postgradmedj-2011-130188 |
| Status: | Peer Reviewed |
| Publication Status: | Published |
| Access rights to Published version: | Restricted or Subscription Access |
| References: | [1] Leeds JS, Hopper AD, Sanders DS. Coeliac Disease. Br Med Bull |
| URI: | http://wrap.warwick.ac.uk/id/eprint/50135 |
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