Transglutaminase antibodies – IgA

Indication

Suspicion of coeliac disease (CD) or dermatitis herpetiformis.

Method

ELISA with human transglutaminase as antigen.

Answer

The result is given as a ratio between patient serum and normal serum. 

Interpretation

Tissue transglutaminase (tTG) is an enzyme that crosslinks proteins in tissues. The antigen of endomysium in CD serology is transglutaminase. IgA anti-transglutaminase antibodies, which are analyzed with ELISA, correlate very well with anti-endomysium, which is analyzed with indirect immunofl uorescence. Anti-tTG and anti-endomysium have almost 100 % specifi city in clinical celiac disease. A positive result with IgAantibodies (IgG in IgA deficient patients) confi rms the CD diagnosis, but the final diagnosis must still be based on a small intestine biopsy and clinical remission on a GFD. However, new diagnostic criteria are being discussed, which may make the the biopsy redundant given classical symptoms suggesting CD, high titers of anti-DGP antibodies and/or anti-transglutaminase (or anti-endomysial) antibodies, predisposingHLA genotype (DQ 2/8) and improvement on a GFD.

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