Antiendomysium antibodies assay in the culture medium of intestinal mucosa: an accurate method for celiac diseasediagnosis

Pasquale Mansueto, Ada Maria Florena, Maurizio Soresi, Antonio Carroccio, Gaetana Di Fede, Carmelo Sciume', Girolamo Geraci, Giuseppina Campisi, Ilenia Pepe, Ilenia Pepe, Giuseppe Ambrosiano, Saverio Teresi, Antonio Carroccio, Lidia Di Prima, Pasquale Mansueto, Gaetana Di Fede, Francesca Cavataio, Giuseppe Iacono, Maurizio Soresi, Giuseppe PirroneGiuseppe Ambrosiano, Giuseppe Pirrone, Lidia Di Prima

Research output: Contribution to journalArticlepeer-review

24 Citations (Scopus)

Abstract

Background Celiac disease (CD) diagnosis is becoming more difficult as patients with no intestinal histology lesions may also be suffering from CD. Aim To evaluate the diagnostic accuracy of antiendomysium (EmA) assay in the culture medium of intestinal biopsies for CD diagnosis. Patients and methods The clinical charts of 418 patients with CD and 705 non-CD controls who had all undergone EmA assay in the culture medium were reviewed. Results EmA assay in the culture medium had a higher sensitivity (98 vs. 80%) and specificity (99 vs. 95%) than serum EmA/antibodies to tissue transglutaminase (anti-tTG) assay. All patients with CD who were tested as false-negatives for serum EmA and/or anti-tTG (32 adults and 39 children) carried the human leukocyte antigen alleles associated to CD. Furthermore, during the follow-up, four patients with negative-serum EmA/anti-tTG, normal villi architecture, and positive-EmAs in the culture medium, developed villous atrophy and underwent gluten-free diet with consequent resolution of the symptoms and complete intestinal histology recovery. Conclusion EmA assay in the culture medium should be included in the diagnostic criteria for CD diagnosis in 'seronegative' patients. Eur J Gastroenterol Hepatol 23:1018-1023 (C) 2011 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.
Original languageEnglish
Pages (from-to)1018-1023
Number of pages6
JournalEUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY
Volume23
Publication statusPublished - 2011

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

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