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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. doi:10.1136/postgradmedj-2011-130188

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Official URL: http://dx.doi.org/10.1136/postgradmedj-2011-130188

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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 Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Biomedical Sciences > Translational & Experimental Medicine > Metabolic and Vascular Health (- until July 2016)
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
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
Dates:
DateEvent
August 2013Published
Volume: Volume 89
Number: Number 1047
Page Range: pp. 4-7
DOI: 10.1136/postgradmedj-2011-130188
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Restricted or Subscription Access

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