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Clinical Chemistry 51: 1014-1016, 2005. First published March 24, 2005; 10.1373/clinchem.2004.047233
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(Clinical Chemistry. 2005;51:1014-1016.)
© 2005 American Association for Clinical Chemistry, Inc.

Technical Briefs

Use of Low Concentrations of Human IgA Anti-Tissue Transglutaminase to Rule Out Selective IgA Deficiency in Patients with Suspected Celiac Disease,

Eloy Fernández1,a, Carlos Blanco1, Sara García1, Angeles Dieguez2, Sabino Riestra3 and Luis Rodrigo3

1 Biochemistry Department, Hospital Cabueñes, Gijón, Spain;2 Immunology and 3 Gastroenterology Departments, Hospital Central Asturias, Oviedo, Spain;

aaddress correspondence to this author at: Biochemistry Department, Hospital de Cabueñes, Cabueñes s/n, 33394 Gijón, Asturias, Spain; fax 34-985185022, e-mail eloy.fernandez@sespa.princast.es

The first 300 words of the full text of this article appear below.

Selective IgA deficiency (IgAD) is the most common well-defined primary immunodeficiency disorder in humans (1)(2). Patients with IgAD frequently share the haplotype HLA-DQ2, which is also associated with celiac disease (CD) (3), and therefore have a 10- to 20-fold increased risk of CD (4).

High concentrations of anti-tissue transglutaminase (h-tTG) IgA antibody are used to diagnose CD (5)(6), but antibodies are not increased in IgAD (7)(8). This has led to the use of assays for total IgA when testing for CD and/or testing for IgG-class antibodies against h-tTG (9).

The aim of our study was to assess whether a second-generation IgA anti-h-tTG assay can detect IgAD, as the concentrations of IgA antibodies would be expected to be very low. This could eliminate the expense for additional tests in many individuals.

We studied 4 groups of patients. The disease group included 28 patients with IgAD [18 females (median age, 38 years; range, 8–79 years) and 10 males (median age, 24 years; range, 5–75 years)] diagnosed between June 2001 and May 2003. All had total IgA concentrations <0.05 g/L and normal concentrations of IgG and IgM and had a clinical diagnosis of IgAD. The diseased control group consisted of 63 patients [32 males (median age, 56 years; range, 1–92 years) and 31 females (median age, 31 years; range, 1–82 years)] in whom total IgA was >0.05 g/L but below the lower limit of the reference interval (0.70 g/L; median IgA, 0.39 g/L; range, 0.07–0.69 g/L). The final diagnoses in the adult diseased controls were multiple myeloma (30 patients), chronic lymphoid leukemia (4), anemia (4), chronic kidney failure (4), Waldestrom disease (3), acute pulmonary edema (2), scleroderma (1), and acute pericarditis (1). The 14 pediatric . . . [Full Text of this Article]




The following articles in journals at HighWire Press have cited this article:


Home page
 Clin. Chem.Home page
K. E. McGowan, M. E. Lyon, and J. D. Butzner
Celiac Disease and IgA Deficiency: Complications of Serological Testing Approaches Encountered in the Clinic
Clin. Chem., July 1, 2008; 54(7): 1203 - 1209.
[Abstract] [Full Text] [PDF]

Home page
 Clin. Chem.Home page
K. E. McGowan, M. E. Lyon, S. D. Loken, and J. D. Butzner
Celiac Disease: Are Endomysial Antibody Test Results Being Used Appropriately?
Clin. Chem., October 1, 2007; 53(10): 1775 - 1781.
[Abstract] [Full Text] [PDF]

Home page
 J. Clin. Pathol.Home page
D Sinclair, M Saas, A Turk, M Goble, and D Kerr
Do we need to measure total serum IgA to exclude IgA deficiency in coeliac disease?
J. Clin. Pathol., July 1, 2006; 59(7): 736 - 739.
[Abstract] [Full Text] [PDF]


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