Lege Artis Medicinae

[Technical considerations to the anti-endomysium antibody assay]

KORPONAY-SZABÓ Ilma1, B. KOVÁCS Judit1, LŐRINCZ Margit1, KÖRMENDY Miklós1, SASHEGYI Julianna1

FEBRUARY 28, 1994

Lege Artis Medicinae - 1994;4(02)

[Anti-endomysium antibody and its equivalent anti-jejunum antibody were investigated in 5000 and 3444 serum samples, respectively. 2928 persons, among them 441 are known gluten intolerant patients (170 coeliac disease proven by gluten challenge, 95 dermatitis herpetiformis, 176 suspected coeliac disease with at least one jejunal biopsy result showing severe villous atrophy); 251 by biopsy proven non coeliac children served as controls. The mentioned antibodies were detected by indirect immuno fluorescence in IgA (in IgA-deficient persons also in IgG) subclass. Specificity of both anti-endomysium and anti-jejunum antibody results was 100% for gluten intolerance. Sensitivity in gluten consuming patients was: 100% in proven coeliac disease (66/66), 92,4% (61/66) in dermatitis herpetiformis and 85,9% (110/ 128) in suspected coeliac disease. 13,5% of all sera contained aspecific IgA-stainings of the following types: anti-smooth muscle, basement membrane, pemphigoid-like and anti-nuclear faktor like antibodies. Simultaneous positivity for anti-endomysium and aspecific antibodies occured too. Assessment accuracy have been improved with the use of 8–10 microns thick tissue sections. Detection of this specific autoantibodies merits first line use in the diagnosis of gluten sensitive enteropathy, but specialized laboratory centers are needed to overcome technical pitfalls. ]

AFFILIATIONS

  1. Fővárosi Önkormányzat Heim Pál Gyermekkórház Budapest

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