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首页> 外文期刊>Clinical and diagnostic laboratory immunology >Immunoglobulin A (IgA) Deficiency and Alternative Celiac Disease-Associated Antibodies in Sera Submitted to a Reference Laboratory for Endomysial IgA Testing
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Immunoglobulin A (IgA) Deficiency and Alternative Celiac Disease-Associated Antibodies in Sera Submitted to a Reference Laboratory for Endomysial IgA Testing

机译：免疫球蛋白A（IgA）缺乏和血清中与其他腹腔疾病相关的抗体已提交给参考实验室进行肌内膜IgA测试

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Immunoglobulin A (IgA) deficiency occurs more frequently in patients with celiac disease (CD) than in the general population and can lead to false-negative results in the best serologic test for CD, endomysial IgA (EMA). To evaluate the impact of IgA deficiency on serologic detection of CD in a reference laboratory setting, IgA levels were measured in 510 consecutive serum specimens submitted for testing for EMA; 510 consecutive serum specimens submitted forHelicobacter pylori IgG testing served as a gastrointestinal symptom control group. The frequency of IgA deficiency was significantly higher among the specimens submitted for testing for EMA (5.1%) than among the specimens from the symptom control group (1.4%). Three subsets of sera from the group of specimens submitted for testing for EMA were then tested by additional serologic assays for CD; these subsets were EMA-positive sera (n = 25), EMA-negative, IgA-deficient sera (n = 26), and control sera (from EMA-negative, IgA-nondeficient patients age matched to IgA-deficient patients; n = 26). The proportions of EMA-positive sera positive by other assays for CD were 92% for transglutaminase IgA (TG-IgA), 80% for gliadin IgA, 84% for gliadin IgG, 60% for endomysial IgG (EMG), and 32% for transglutaminase IgG (TG-IgG). Very low proportions (0 to 8%) of IgA-deficient sera and control sera were positive for TG-IgA, gliadin IgA, EMG, and TG-IgG. Eight of 26 (31%) IgA-deficient serum samples were positive for gliadin IgG, whereas 3 of 26 (12%) control serum samples were positive for gliadin IgG, but this difference was not statistically significant. Physicians supplied clinical data for 18 of 26 patients with IgA deficiency; only 4 patients had undergone small-bowel biopsy, and 0 of 4 patients showed villous atrophy. These findings show that IgA deficiency is found more frequently among sera submitted for testing for EMA in a reference laboratory setting, but there was no clear-cut serologic or clinical evidence of CD in EMA-negative, IgA-deficient patients.
机译：腹腔疾病（CD）患者的免疫球蛋白A（IgA）缺乏症比普通人群更常见，在CD的最佳血清学检查中，肌内膜IgA（EMA）可能导致假阴性结果。为了评估在参考实验室环境中IgA缺乏对CD血清学检测的影响，在510份连续样品中进行了EMA检测，测量了IgA水平。连续510例接受幽门螺杆菌IgG检测的血清标本作为胃肠道症状对照组。提交进行EMA测试的标本中IgA缺乏症的发生率（5.1％）明显高于症状对照组的标本（1.4％）。然后，通过附加的血清学CD检测方法对提交用于EMA测试的标本组中的三份血清进行了检测;这些子集是EMA阳性血清（ n = 25），EMA阴性，IgA缺乏血清（ n = 26）和对照血清（来自EMA阴性， IgA缺陷患者的年龄与IgA缺陷患者的年龄相匹配; n = 26）。通过其他CD检测阳性的EMA阳性血清的比例分别为转谷氨酰胺酶IgA（TG-IgA）92％，麦醇溶蛋白IgA 80％，麦醇溶蛋白IgG 84％，肌内膜IgG（EMG）60％和32％转谷氨酰胺酶IgG（TG-IgG）。 IgA缺陷血清和对照血清中极低比例（0％至8％）的TG-IgA，麦醇溶蛋白IgA，EMG和TG-IgG呈阳性。 26例IgA缺陷血清样本中有8例麦醇溶蛋白IgG呈阳性，而26例对照血清样本中有3例（12％）醇溶蛋白IgG呈阳性，但这一差异在统计学上无统计学意义。医师为26名IgA缺乏症患者中的18名提供了临床数据。仅4例接受了小肠活检，4例中的0例显示绒毛萎缩。这些发现表明，在参考实验室环境中，在提交进行EMA检测的血清中发现IgA缺乏症的频率更高，但是在EMA阴性，IgA缺乏的患者中没有明确的CD血清学或临床证据。

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