INDIVIDUAL TEST 147

Transglutaminase (tTG) IgG-antibodies

Indication

Suspicion of celiac disease (CD) in IgA-deficient patients

Method

ELIA

Answer

The result is reported as negative, borderline or positive with a value (U/ml).

Interpretation

Tissue transglutaminase (tTG) is an enzyme that crosslinks proteins in tissues. The antigen of endomysium in CD serology is transglutaminase. IgA anti-transglutaminase antibodies, which are analyzed with ELISA, correlate very well with anti-endomysium, which is analyzed with indirect immunofluorescence. Anti-tTG and anti-endomysium have almost 100 % specificity in clinical celiac disease. A positive result with IgA antibodies (IgG in IgA deficient patients) confirms the CD diagnosis, but the final diagnosis must still be based on a small intestine biopsy and clinical remission on a GFD. However, new diagnostic criteria are being discussed, which may make the biopsy redundant given classical symptoms suggesting CD, high titers of anti-DGP antibodies and/or anti-transglutaminase (or anti-endomysial) antibodies, predisposing HLA genotype (DQ 2/8) and improvement on a GFD.

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Autoimmune diagnostics

ENSKILD ANALYS 147

Transglutaminas(tTG) IgG-antikroppar

Indikation

Misstanke om celiaki vid IgA-brist

Metod

ELIA

Svar

Resultat rapporteras som negativt, gränsvärde eller positivt med värde (U/ml).

Tolkning

IgG antikroppar mot transglutaminas (tTG) är markör för celiaki vid IgA-brist. Förutsatt att IgA-brist inte föreligger rekommenderas analys av IgA-antikroppar mot tTG i första hand vid utredning av misstänkt celiaki. Se klinisk immunologis nationella riktlinjer för utredning av misstänkt celiaki.

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Autoimmun diagnostik