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

World Journal of Gastroenterology 2012年第20期18卷 2511-2516页

作者： Kalle Kurppa Tiia Rsnen Pekka Collin Sari Iltanen Heini Huhtala Merja Ashorn Pivi Saavalainen Katri Haimila Jukka Partanen Markku Mki Katri Kaukinen Pediatric Research Centre University of Tampere and Tampere University HospitalFin-33014Tampere Finland Department of Gastroenterology and Alimentary Tract Surgery Tampere University Hospital and School of MedicineUniversity of TampereFin-33014 TampereFinland Tampere School of Public Health University of TampereFin-33014TampereFinland Department of Medical Genetics and Research Program for Molecular Medicine University of Helsinki Fin-00014HelsinkiFinland Research and Development Finnish Red Cross Blood ServiceFin-00310HelsinkiFinland

AIM:To investigate the association between serum antibody levels and a subsequent celiac disease diag-nosis 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 *** 405 patients underwent clinical,serological and histological *** 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 ***, 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.

关键词： Celiac disease Diagnosis endomysial antibodies Transglutaminase 2 antibodies Clinical presentations

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