首页|Endomysial antibodies predict celiac disease irrespective of the titers or clinical presentation

Endomysial antibodies predict celiac disease irrespective of the titers or clinical presentation

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AIM:To investigate the association between serum antibody levels and a subsequent celiac disease diagnosis in a large series of children and adults.METHODS:Besides subjects with classical gastrointestinal presentation of celiac disease,the study cohort included a substantial number of individuals with extraintestinal symptoms and those found by screening in at-risk groups.Altogether 405 patients underwent clinical,serological and histological evaluations.After collection of data,the antibody values were further graded as low [endomysial (EmA) 1:5-200,transglutaminase 2 antibodies (TG2-ab) 5.0-30.0 U/L] and high (EmA 1:≥ 500,TG2-ab ≥ 30.0 U/L),and the serological results were compared with the small intestinal mucosal histology and clinical presentation.RESULTS:In total,79％ of the subjects with low and 94％ of those with high serum EmA titers showed small-bowel mucosal villous atrophy.Furthermore,96％ of the 47 EmA positive subjects who had normal mucosal villi and remained on follow-up either subsequently developed mucosal atrophy while on a glutencontaining diet,or responded positively to a glutenfree diet.CONCLUSION:Irrespective of the initial serum titers or clinical presentation,EmA positivity as such is a very strong predictor of a subsequent celiac disease diagnosis.

Celiac diseaseDiagnosisEndomysial antibodiesTransglutaminase 2 antibodiesClinical presentations

Kalle Kurppa、Tiia R(a)s(a)nen、Pekka Collin、Sari Iltanen、Heini Huhtala、Merja Ashorn、P(a)ivi Saavalainen、Katri Haimila、Jukka Partanen、Markku M(a)ki、Katri Kaukinen

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Pediatric Research Centre, University of Tampere and Tampere University Hospital, Fin-33014, Tampere,Finland

Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital and School of Medicine, University of Tampere, Fin-33014,Tampere, Finland

Tampere School of Public Health, University of Tampere, Fin-33014, Tampere, Finland

Department of Medical Genetics and Research Program for Molecular Medicine, University of Helsinki, Fin-00014, Helsinki, Finland

Research and Development,Finnish Red Cross Blood Service, Fin-00310, Helsinki, Finland

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Academy of Finland Research Council for HealthCompetitive Research Funding of the Pirkanmaa Hospital DistrictSigrid Juselius FoundationFoundation for Paediatric ResearchNational Graduate School of Clinical InvestigationEhrnrooth FoundationFinnish Gastroenterology SocietyFinnish Pediatric SocietyFinnish Celiac Society

2012

10.3748/wjg.v18.i20.2511

世界胃肠病学杂志(英文版)
太原消化病研治中心

世界胃肠病学杂志(英文版)

SCI
影响因子：1.001
ISSN：1007-9327
年,卷(期)：2012.18(20)
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