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

作者：Carroccio Antonio^*; Iacono Giuseppe; Di Prima Lidia; Pirrone Giuseppe; Cavataio Francesca; Ambrosiano Giuseppe; Sciume Carmelo; Geraci Girolamo; Florena Ada; Teresi Saverio; Barbaria Franco; Pepe Ilenia; Campisi Giuseppina; Mansueto Pasquale; Soresi Maurizio; Di Fede Gaetana

来源：European Journal of Gastroenterology and Hepatology, 2011, 23(11): 1018-1023.

DOI：10.1097/MEG.0b013e328349b8a5

• celiac disease
• culture system
• diagnosis
• intestinal histology
• serum antiendomysium

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.

• 出版日期2011-11