Positive tests for serum anti-endomisium antibodies (AEA) and anti-jejunal antibodies (JAB) and histopathological diagnosis of celiac disease in children
Authors:
Pe Makovický 1; Pa Makovický 1; M. Klimik 2; M. Greguš 3; M. Zimmermann 4
Authors‘ workplace:
Ústav patológie FN Nitra, Slovenská republika, prednosta doc. MUDr. Dušan Ďurčanský, CSc.
1; Oddelenie klinickej imunológie FN Nitra, Slovenská republika, prednosta prim. MUDr. Michal Klimik
2; Gastroenterologické oddelenie Nitra, Slovenská republika, prednosta prim. MUDr. Miloš Greguš
3; Ústav klinickej mikrobiológie FN Nitra, Slovenská republika, prednostka mim. prof. MUDr. Anna Líšková, Ph. D.
4
Published in:
Vnitř Lék 2008; 54(1): 25-30
Category:
Original Contributions
Overview
Non-invasive examination methods are increasingly important in diagnosing celiac disease. New options for diagnosing celiac disease have been discovered in addition to the established biochemical, hematological and other methods as a result expansive progress of clinical genetics and immunology. At the same time, detection of circulating auto-antibodies is becoming ever more frequent in clinical practice. As a result, many new, clinically highly heterogeneous cases of the disease have been diagnosed and consequently the prevalence of the disease in both child and adult population has grown. Detection of anti-endomysial antibodies (AEA), characteristic for their high sensitivity and specificity, plays an important role in diagnosing and monitoring celiac disease in pediatric practice. Nevertheless, histopathological diagnosis remains the critical tool for definitive diagnosis of the disease. The article refers to relations between the degree of positivity of AEA and JAB antibodies in the IgA class and the respective grade in the Marsh grading system. The objective of the study was to examine AEA and JAB antibodies and the histological picture of the duodenal mucosa in 20 children and adolescents with celiac disease aged from 2 to 18 years. The authors developed a semiquantitative scale of positivity of both the antibodies, which they compared trying to find a correlation between these and the histopathological picture of the duodenal mucosa. The authors point out the need of timely determination of AEA and t-TG (tissue transglutaminase) in patients whose anamnesis, clinical picture or laboratory results may be indicative of celiac disease.
Key words:
anti-endomisium antibodies – anti-jejunal antibodies – celiac disease – fibrin – Marsh grading system
Sources
1. Berger E. Zur allergischen pathogenese der cöliakie. Bibliotheca Paediatrica 1958; 67(Suppl 1): 55-56.
2. Buc M. Celiakia - súčasný pohľad na imunopatogenézu choroby. Int Med 2004; 4: 352-357.
3. Burgin-Wolf A, Gaze H, Hadziselimovic F et al. Antigliadin and antiendomysium antibody determination for coeliac disease. Arch Dis Child 1991; 66: 941-947.
4. Dewar D, Pereira SP, Ciclitira PJ. The pathogenesis of coeliac disease. Int J Biochem Cell Biol 2004; 36: 17-24.
5. Dietrich W, Ehnis T, Bauer M et al. Identification of tissue transglutaminase as the autoantigen of celiac disease. Nat Med 1997; 50: 797-801.
6. Dvořák M. Biochemická vyšetření u malabsorpčního syndromu. Prakt Lék 1992; 72: 24-26.
7. Dvořák M. Glutenová enteropathie v pohledu praktického lékaře. Prakt Lék 1998; 78: 326-327.
8. Farrell RF, Kelly CP. Diagnosis of celiac sprue. Am J Gastro 2001; 96: 3237-3246.
9. Ferreira M, Davies SL, Butler M et al. Endomysial antibody: is the best screening test for coeliac disease? Gut 1992; 33: 1633-1637.
10. Frič P. Celiakální sprue (aktuální přehled). Vnitř Lék 2003; 49: 465-473.
11. Frič P, Zavoral M. Céliakální sprue dospělých - opomíjená choroba. Prakt Lék 2003; 83: 62-65.
12. Goldemund K. Celiakie. Pediatrie pro praxi 2001; 2: 106-111.
13. Gregar I, Kolek A, Kojecký Z et al. Celiakie dospělých - klinické projevy a přidružená onemocnění. Prakt Lék 2000; 80: 617-620.
14. Chorselski TP, Sulej J, Tchorsewska H et al. IgA class endomysium antibodies in dermatitis herpetiformis and celiac disease, 325-334. In: Beutner EH, Nisengard RJ, Albibi B (eds.): Defined-immunofluorescence and related cytochemical methods. Ann NY Acad Sci 1983.
15. Ilavská A, Paulovičová E, Mikulecký M. Význam vyšetrenia sérologických markerov u pacientov s celiakiou. Čas Lék Čes 2002; 141: 487-490.
16. Ilavská A, Beňo I, Gomolčák P et al. Môžu byť sérologické markery ukazovateľom diétnych chýb u pacientov s celiakiou? Vnitř Lék 2004; 50: 208-212.
17. Janatková I, Malíčková K, Fučíková T et al. Diagnostický přínos stanovení autoprotilátek u gluten-senzitivní enteropatie. Epidemiol Mikrobiol Imunol 2002; 51: 125-130.
18. Kárpáti S, Török E, Kósnai I. IgA class antibody against human jejunum in sera of children with dermatitis herpetirormis. J Invest Derm 1986; 87: 703-706.
19. Kočna P Glutenová enteropathie - nové diagnostické přístupy a screening, 20-23. In: 3. Sjezd Společnosti klinické biochemie. Hradec Králové, 1997.
20. Kohout P. Diagnostika a léčba celiakie. Int Med 2006; 7-8: 324-326.
21. Kotalová R, Nevoral J, Šmídová J. Tkáňové protilátky v diagnostice celiakální sprue. Čes Slov Pediat 1996; 51: 680-687.
22. Kumar V, Lerner A, Valeski JE et al. Endomysial antibodies in the diagnosis of celiac disease and the effect of gluten on antibody titers. Immunol Invest 1989; 18: 533-544.
23. Lukáš Z, Blatný J, Litzman J et al. Diagnostika celiakální sprue. Čes Slov Pediat 1999; 54: 566-571.
24. Meško D, Pullmann R, Nosáľová G. Vademékum klinickej biochémie. Martin: Osveta 1998. 1647 s.
25. Michalík I, Bauerová M. Celiakálne ochorenie známe i neznáme. Výživa a zdravie 2001; 46: 10-12.
26. Nevoral J, Kotalová R. Celiakie I. část - Historie, etiopatogeneze, morfologie, protilátky. Čes Slov Pediat 1993; 48: 426-429.
27. Páv I. Celiakia v ambulantnej praxi. Via Pract 2006; 3: 22-24.
28. Pozler O, Nožička Z, Slížová D et al. Sérové protilátky proti endomysiu a proti retikulinu. Prakt Lék 1997; 77: 332-335.
29. Pozler O, Neumann D. Diabetes a celiakie. Vnitř Lék 2004; 50: 412-414.
30. Prokopová L. Celiakie - závažné onemocnění. Vnitř Lék 2003; 49: 474-481.
31. Seah PP, Fry L, Hoffbrand AV et al. Tissue antibodies in dermatitis herpetiformis and adult coeliac disease. Lancet 1971; 1: 834 - 836.
Labels
Diabetology Endocrinology Internal medicineArticle was published in
Internal Medicine
2008 Issue 1
Most read in this issue
- The use of galactomannan detection in diagnosing invasive aspergilosis in hemato-oncological patients
- Assessment of plasmatic cell proliferation and apoptosis indexes in the course of multiple myeloma
- Statin pharmacokinetics
- Positive tests for serum anti-endomisium antibodies (AEA) and anti-jejunal antibodies (JAB) and histopathological diagnosis of celiac disease in children