INVESTIGADORES
CHIRDO Fernando Gabriel
artículos
Título:
Evaluation of coeliac disease serological markers (anti-gliadin, anti-endomysium, anti transglutaminase antibodies) in Down Syndrome patients.
Autor/es:
RUMBO M; CHIRDO F; BEN R
Revista:
DIGESTIVE AND LIVER DISEASE
Editorial:
PACINI EDITORE
Referencias:
Año: 2002 vol. 34 p. 112 - 116
ISSN:
1590-8658
Resumen:
Background: The increased incidence of Coeliac Disease (CD) among patients with Down Syndrome (DS) makes advisable the screening of CD on this population.
Aims: Evaluation of efficiency of different serological markers to detect CD in DS patients.
Patients: 56 DS patients (aged: 1-17 years old) were included in the study.
Methods: Patients were evaluated for both IgG and IgA anti-transglutaminase antibodies (anti-tTG) and for anti-gliadin IgA and IgG antibodies (AGA) using either purified -gliadin, wheat ethanol extract and commercial gliadin. Patients who had at least one positive result were evaluated for anti-endomysium antibodies (EMA) using either monkey oesophagus and human umbilical cord by indirect immunofluorescence. CD was diagnosed by typical hystological changes on duodenal mucosa.
Results: Increased levels of at least one AGA marker were found in 27 out of 56 cases (26 for IgG and 9 for IgA). 11/ 56 were positive for IgG anti-tTG and two of them were also positive for IgA anti-tTG and EMA. These two patients were finally diagnosed as coeliacs. Gliadin antigenic fractions employed produced differences in the performance of the AGA test. The use of commercial gliadin or wheat ethanol extract showed low sensitivity in IgA AGA determination, whereas good sensitivity and specificity were observed with -gliadins. IgG anti-tTG showed a high proportion of false positive results (9 out of 56), whereas EMA and IgA anti tTG presented an excellent correlation with the presence of active CD.
Conclusions: Two of 56 DS patients were diagnosed as coeliacs, corresponding to an incidence of 3.6%. The use of -gliadin presented the best efficiency in AGA determination whereas IgA anti-tTG and EMA determination showed an absolute correlation with the presence of active coeliac disease.
