Anti-tissue transglutaminase antibodies not related to gluten intake
Por:
Garcia-Peris M, Donat Aliaga E, Roca Llorens M, Masip Simó E, Polo Miquel B and Ribes Koninckx C
Publicada:
1 nov 2018
Categoría:
Pediatrics, perinatology and child health
Resumen:
Introduction: Anti-tissue transglutaminase antibodies (tTG) have high specificity for coeliac disease (CD). However, positive anti-tTG antibodies have been described in non-coeliac patients.
Aim To assess positive anti-tTG antibodies not related to gluten intake.
Patients and methods: Retrospective review and follow up conducted on patients with suspected CD (increase anti-tTG levels and gastrointestinal symptoms) but with atypical serology results, positive anti-tTG with gluten free diet and a decrease in anti-tTG levels despite gluten intake.
Results: A total of 9 cases were reviewed in which 5 cases had Marsh 3 involvement in the initial biopsy, and were diagnosed with CD (Group A). They began a gluten free diet and also a cow's milk protein (CMP) free diet because of their nutritional status. When CMP was re-introduced, anti-tTG increased, and returned to normal after the CMP was withdrawn again. The other 4 patients had a normal initial biopsy (Group B). Gluten was not removed from their diet, but they started a CMP free diet because a non IgE mediated CMP allergy was suspected. Symptoms disappeared, and anti-tTG was normal after CMP free diet with gluten intake. All the patients had susceptibility haplotype HLA DQ2/DQ8.
Conclusions: CMP ingestion after an exclusion diet can induce an increase in anti-tTG in some coeliac subjects. CMP can produce this immune response if there were no gluten transgressions. This response has also been observed in non-IgE mediated CMP allergy patients with the susceptibility haplotype HLA DQ2/DQ8. (C) 2017 Asociacion Espanola de Pediatria. Published by Elsevier Espana, S.L.U.
Filiaciones:
:
Servicio de Pediatría, Hospital Lluís Alcanyís, Xàtiva (Valencia), España
Donat Aliaga E:
Unidad de Gastroenterología Pediátrica, Hospital Universitari i Politécnic La Fe, Valencia, España
Unidad de Enfermedad Celíaca e Inmunopatología Digestiva, Instituto de Investigación Sanitaria La Fe, Valencia, España
Roca Llorens M:
Unidad de Enfermedad Celíaca e Inmunopatología Digestiva, Instituto de Investigación Sanitaria La Fe, Valencia, España
Masip Simó E:
Unidad de Gastroenterología Pediátrica, Hospital Universitari i Politécnic La Fe, Valencia, España
Unidad de Enfermedad Celíaca e Inmunopatología Digestiva, Instituto de Investigación Sanitaria La Fe, Valencia, España
Polo Miquel B:
Unidad de Gastroenterología Pediátrica, Hospital Universitari i Politécnic La Fe, Valencia, España
Unidad de Enfermedad Celíaca e Inmunopatología Digestiva, Instituto de Investigación Sanitaria La Fe, Valencia, España
Ribes Koninckx C:
Unidad de Gastroenterología Pediátrica, Hospital Universitari i Politécnic La Fe, Valencia, España
Unidad de Enfermedad Celíaca e Inmunopatología Digestiva, Instituto de Investigación Sanitaria La Fe, Valencia, España
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