This paper should be cited as: Shadman, M. Abedian Kenari, S. Alizadeh, A. Kaveh, M. Hosseini, V.

Anti-Endomysial and Anti-Tissue Transglutaminase Serological Test Compared with Small Bowel Biopsy in the Diagnosis of Celiac Disease

Shadman, M. (MSc)1, Abedian Kenari, S. (PhD)*2, Alizadeh, A. (PhD)3, Kaveh, M. (MSc)4, Hosseini, V. (MD)5

 

1. MSc of Immunology, Department of Immunology, Mazandaran University of Medical Science, Sari, Iran

2. Associated Professor of Immunology, Immunogenetic Research Center, School of Medicine, Mazandaran University of Medical Science, Sari, Iran

3. PhD of Biostatistics, Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran

4. MSc of Immunology, Department of Immunology, Yazd University of Medical Science

5. Assistant Professor of Internal Medicine, Imam Hospital, Mazandaran University of Medical Sciences, Sari, Iran

Abstract
Background and Objective: Celiac is an autoimmune disease that is characterized by an immune-system-related damage in the intestinal tissue after consumption of gluten. There is not any general agreement for gold standard. The Purpose of this study was the evaluation of specificity and sensitivity of anti-endomysial (EMA) and anti-tissue transglutaminase (TTG) serological test compared to small-bowel biopsy.

Material and Methods: In the cross sectional study, we took blood specimen from 1825 patients with gastrointestinal disease. All the samples were tested by TTG and EMA kits using ELISA. The patients were studied in two groups. First, the individuals whom their serologic test was positive but their tissue condition was normal and second, those with positive serologic test with pathologic tissue results that show they have celiac disorder.

Results: The mean of EMA and TTG shows that the level of antibodies in group 2 is significantly higher than that of the first group (P ≤0.001). There is positive correlation between modified marsh criteria of small-bowel biopsy and the two tests. The Sensitivity of EMA and TTG tests for celiac diagnosis is 92%. The specificity of EMA, TTG tests are 100% and 98.5%, respectively.

Conclusion: EMA-IgA serology with cut-off point of more than 66 together with TTG-IgA serology with cut-off point of above 30 can be helpful to distinguish a wide range of patients who need small-bowel biopsy.

Keywords: Celiac; Anti-tissue Transglutaminase (TTG); Anti-endomysial (EMA)

Corresponding author: Abedian Kenari, S.

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Received: 17 Nov 2012
Revised: 16 Mar 2013
Accepted: 17 Mar 2013