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Lupus
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Insights in the Laboratory Diagnosis of Celiac Disease

D Basso

Departments of Laboratory Medicine

G Guariso

Pediatrics

P Fogar

Medical and Surgical Sciences, University of Padova, Italy

F Navaglia

Departments of Laboratory Medicine

C-F Zambon

Medical and Surgical Sciences, University of Padova, Italy

M Plebani

Departments of Laboratory Medicine, mario.plebani{at}unipd.it

The present report focuses on the diagnosis of celiac disease and its pathogenesis, which depends on a genetic predisposition (HLA DQ2 or DQ8 haplotypes), gluten ingestion and T cell activation, type II transglutaminase (TG2), the autoantigen recognized by the antiendomysial antibody playing a key role. IgA class antibody anti-environmental (gliadin) and endogenous (TG2) antigens are present in the sera of patients with celiac disease. The anti-TG2 antibody has the best available diagnostic accuracy, especially when measured employing second generation ELISA tests, which use the human TG2 antigen, or immunochemiluminescent assay, which is highly sensitive. A diagnosis of celiac disease must always be confirmed by the histological evaluation of multiple duodenal mucosa specimens, and serology is recommended for follow-up controls.

Key Words: anti-endomysium • anti-transglutaminase • celiac disease • chemiluminescence • ELISA • gluten free diet

Lupus, Vol. 15, No. 7, 462-465 (2006)
DOI: 10.1191/0961203306lu2334oa
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