The serum IgA class anti-tissue transglutaminase antibodies in the diagnosis and follow up of coeliac disease. Results of an international multi-centre study

E. Fabiani, C. Catassi, S. De Rosa, N. Litwin, H. Ellemunter, J. Eder, L. Gandolfi, R. Pratesi, S. Sulkanen, M. Máki, A. Baquey, T. Lamireau, F. Bienvenu, G. Beaune, J. Schmitz, A. M. Yamamoto, J. Schellscheidt, K. P. Zimmer, M. Stern, F. M. StevensM. Kearns, C. Catassi, E. Fabiani, M. Baldassarre, G. Di Bitonto, M. Masi, R. Lazzari, P. Lionetti, G. Massai, M. Cingolani, E. Castellano, C. Sferlazzas, G. Di Pasquale, G. Barera, P. Roggero, F. Balli, L. Viola, R. Troncone, G. Iovine, G. Guariso, M. Plebani, F. Cataldo, P. Greco, F. Cavataio, M. Di Gregorio, G. L. De Angelis, M. Manfredi, G. Ferraro, G. Castellucci, C. Romano, A. Caccamo, F. Colistro, M. Castro, F. Viola, M. Barbato, M. Vascotto, G. Morgese, N. Ansaldi-Balocco, M. Di Leo, A. Ventura, T. Not, C. J J Mulder, J. Kerckhaert, C. Czismadia, M. L. Mearin, I. Polanco, M. M. Esteban, G. K T Holmes, V. Mendez, A. Fasano, K. Horvath, S. Guandalini, H. Andrew, E. Bravi, M. Caradonna

Research output: Contribution to journalArticlepeer-review


Objectives So far the reliability of the anti-tissue transglutaminase (anti-tTG) test for the diagnosis of coeliac disease has mostly been evaluated using slightly different enzyme-linked immunosorbent assays (ELISAs) in selected and usually small groups of patients. The aims of this study were: (1) to evaluate the reliability of the IgA anti-tTG antibodies for the diagnosis of coeliac disease; and (2) to define the sensitivity and specificity of a commercially available kit for the anti-tTG antibodies' quantitative determination. Design Each centre in this international multi-centre study collected sera from three groups of subjects: coeliac disease patients at the onset of (1) or on a gluten-free diet for at least 12 months (2); disease and healthy controls (3). Methods The anti-tTG antibodies were determined in duplicate using an ELISA-based commercially available kit (Eu-tTG Eurospital, Trieste, Italy). Results The following overall cases and controls have been enrolled: (1) 399 subjects with active coeliac disease; (2) 351 treated coeliac disease cases; (3) 432 controls. The centralized re-testing was performed on: (1) group a: 176 patients with active coeliac disease (mean anti-tTG, 21 arbitrary units [AU]); (2) group b: 172 treated coeliac disease cases (mean anti-tTG, 5 AU); (3) group c: 206 controls (mean anti-tTG, 3 AU). In active coeliacs, the anti-tTG antibodies showed a significant progressive decrease with age, while in controls an opposite trend was found. In active coeliac disease patients, the anti-tTG antibodies were significantly higher in coeliacs with a grade III enteropathy than in those showing a grade II lesion. In treated coeliacs, the mean anti-tTG values were significantly lower in patients strictly adhering to a gluten-free diet than in those reporting dietary transgressions. The sensitivity and the specificity of the Eu-tTG assay were 90% and 96%, respectively. Conclusion The results of this study show that the commercially available test for the anti-tTG antibodies' determination is a reproducible and valuable tool for the diagnosis and follow up of coeliac disease.

Original languageEnglish
Pages (from-to)659-665
Number of pages7
JournalEuropean Journal of Gastroenterology and Hepatology
Issue number6
Publication statusPublished - 2001


  • Coeliac disease
  • Screening
  • Serology
  • Tissue transglutaminase

ASJC Scopus subject areas

  • Gastroenterology


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