Anti-endomysial antibody of IgG1 isotype detection strongly increases the prevalence of coeliac disease in patients affected by type I diabetes mellitus
| Autor: | S. Vetrano, Antonio Picarelli, M.C. Anania, M. Di Tola, Patrizia Gargiulo, M Vergari, C. Casale, Riccardo Schiaffini, L. Sabbatella, Barbara Porowska |
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| Jazyk: | angličtina |
| Rok vydání: | 2005 |
| Předmět: |
Adult
Male Adolescent Duodenum Immunology Population Muscle Fibers Skeletal anti-endomysial antibodies Coeliac disease Antibodies Gliadin organ culture Immunopathology Diabetes mellitus medicine Immunology and Allergy Humans Intestinal Mucosa education coeliac disease igg1 anti-endomysial antibodies type i diabetes mellitus Aged Autoimmune disease Type 1 diabetes education.field_of_study biology business.industry Original Articles Middle Aged medicine.disease Isotype Immunoglobulin A Celiac Disease Diabetes Mellitus Type 1 Immunoglobulin G biology.protein Female Antibody Atrophy business |
| Popis: | Summary A strong association between type 1 insulin-dependent diabetes mellitus (IDDM1) and coeliac disease (CD) is well documented, but it is known that prevalence values are underestimated. Serum anti-endomysial antibodies (EMA), considered diagnostic for CD because of their high sensitivity and specificity, belong to the IgA class, but the existence of EMA of IgG1 isotype in the presence or absence of IgA deficiency was reported. In order to re-evaluate the occurrence of CD in IDDM1 patients we performed a screening in IDDM1 patients using EMA of both isotypes. Ninety-four adults affected by IDDM1 (unaffected by CD before enrolling) were enrolled and 83 blood donors as controls. All subjects were on a gluten-containing diet. Histology and biopsy culture were performed. EMA IgA and IgG1 in sera and culture supernatants were detected. Serum EMA were positive in 13 of 94 IDDM1 patients (13·8%). Six of 13 presented IgA-EMA, seven of 13 presented IgG1-EMA. No EMA were found in the control population. Total intestinal atrophy was found in all six patients with serum IgA-EMA and in five of seven with serum IgG1-EMA. Diagnosis of CD was confirmed by histology and organ culture in all 13 patients with serum EMA. The prevalence of CD in the patients affected by IDDM1 was 6·4% for IgA-EMA-positive and 7·4% for IgG1-EMA-positive patients. We confirmed the prevalence of CD in the IDDM1 population obtained with IgA-EMA screening only (6·4%). This prevalence value increases dramatically to 13·8% when IgG1-EMA are also used in the screening. We conclude that IgG1-EMA should also be sought whenever an IDDM1 patient undergoes screening for CD. |
| Databáze: | OpenAIRE |
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