IgA- and IgG-class antihuman umbilical cord antibody tests in adult coeliac disease

Scand J Gastroenterol. 1998 Mar;33(3):251-4. doi: 10.1080/00365529850170810.

Abstract

Background: An antiendomysium antibody test using human umbilical cord as antigen has recently been introduced.

Methods: We determined IgA- and IgG-class antihuman umbilical cord (HUC-ab), antireticulin (ARA), and antigliadin antibodies (AGA) in 92 untreated adult coeliac patients, in 95 non-coeliac subjects, and in 4 coeliac patients with selective IgA deficiency. Tissue antibodies were measured with an indirect immunofluorescence method and AGA with an enzyme-linked immunosorbent assay.

Results: Of adult coeliac patients 85% were positive for IgA-class HUC-ab, 78% were positive for ARA, and 80% for AGA; the specificity for HUC-ab and ARA was 100%, and for AGA 86%. Combination of HUC-ab, ARA, and high-titre AGA increased the sensitivity to 96% without loss of specificity. IgG-class HUC-ab was positive in 12% of coeliac patients, in all four coeliac patients with IgA deficiency, and in none of the controls.

Conclusions: The HUC-ab test is highly specific but not 100% sensitive for detecting adult coeliac disease. A combination of the IgA-class HUC-ab, ARA, and high-titre AGA tests is recommended. In selective IgA deficiency the IgG-class HUC-ab test seems to work well.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antibodies / analysis
  • Antibodies, Anti-Idiotypic / analysis
  • Celiac Disease / immunology*
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Fluorescent Antibody Technique, Indirect
  • Gliadin / immunology
  • Humans
  • Immunoglobulin A / analysis*
  • Immunoglobulin G / analysis*
  • Male
  • Middle Aged
  • Reticulin / immunology
  • Sensitivity and Specificity
  • Umbilical Cord / immunology*

Substances

  • Antibodies
  • Antibodies, Anti-Idiotypic
  • Immunoglobulin A
  • Immunoglobulin G
  • Reticulin
  • Gliadin