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[The role of anti-endomysium and anti-transglutaminase antibodies in the diagnosis and follow-up of celiac disease].

Available, non invasive, serological tests such as the anti-endomysium antibodies (EmA) and anti-transglutaminase antibodies (Anti-tTg) has allowed better outlining of the clinical presentation as well as the pathogenesis of Coeliac Disease (CD). The aim of the study was to evaluate the reliability and concordance of EmA and anti-tTg at the diagnosis (T0) of CD and after 12 months (T12) of Gluten-Free Diet (GFD). Serum EmA and Anti-tTg were evaluated in 78 patients aged 6.3 +/- 4.7 SD yrs at diagnosis, in 56 of them at T0 and T12, as well as in a control group of 88 children aged 6.9 +/- 3.8 yrs. EmA were evaluated by indirect immunofluorescence and Anti-tTg by ELISA. All subjects had normal circulating IgA levels. In the control group, EmA and Anti-tTg resulted negative in all cases. At T0, 77/78 pts had both EmA and Anti-tTg positive, one pt (1.3%) had only EmA positive, demonstrating an overall positive concordance of 98.7%. At T12, 16 pts (28.6%) had both tests positive, 8 (14.3%) had only Anti-tTg positive (all of them were no fully compliant to GFD) and 32 (57.1%) had both tests negative. The overall concordance at T12 was 85.7%. The concordance between EmA and Anti-tTg at T0 is nearly absolute (98.7%). The higher prevalence of elevated anti-tTg than of positive EmA at T12 suggests a higher sensitivity of anti-tTg following intake of even small amounts of gluten.