2110. Package # 44 (Tissue transglutaminase, IgG, IgA antibodies)

Package No. 44, 'Antibodies to Tissue Transglutaminase,' includes two markers: immunoglobulins A and G against the enzyme tissue transglutaminase.

People with celiac disease cannot consume gluten in any form, including wheat bread, semolina porridge, pasta, etc. When several factors coincide – genetic predisposition, an autoimmune process affecting the villi of the small intestine, and impaired digestion – celiac disease may develop.

The gold standard for diagnosing celiac disease is the detection of serological markers of the disease. Package No. 44 includes testing for antibodies (IgA and IgG) to tissue transglutaminase.

It is used as a screening test for celiac disease in people:

• with a family history of gluten-sensitive enteropathy;
• with autoimmune diseases (type 1 diabetes mellitus, Hashimoto’s autoimmune thyroiditis, systemic connective tissue diseases);
• with Down syndrome.

Celiac disease primarily affects people of European descent; it develops in 10–20% of first-degree relatives. This condition may be congenital or develop against a background of autoimmune inflammation.

The underlying mechanism of celiac disease is increased sensitivity of intestinal cells to gliadin (a component of gluten), as well as a deficiency of enzymes responsible for its breakdown. As a result, gliadin accumulates in the intestinal lumen. This leads to villous atrophy and impaired absorption (gluten-sensitive enteropathy).

IgA and IgG antibodies to tissue transglutaminase are directed against the enzyme transglutaminase, which is involved in the biochemical conversion of gliadin. Under the influence of tissue transglutaminase, gliadin is converted into a more immunogenic peptide, which triggers and sustains an inflammatory process in the intestinal mucosa that eventually leads to its atrophy.

The risk of celiac disease is increased in patients with type 1 diabetes mellitus, autoimmune diseases of the liver and/or thyroid gland, Down syndrome, Turner syndrome, Williams syndrome, IgA nephropathy, IgA deficiency, and in first-degree relatives of patients with celiac disease. The clinical course of celiac disease is variable, ranging from asymptomatic disease to disorders affecting the gastrointestinal (GI) tract, muscular system, genitourinary system, or skeletal system. In adults, the most common symptoms are increased fatigue, general weakness, mildly pronounced transient diarrhea, or bulky, greasy stools (steatorrhea). In children, loss of appetite, weight loss, pallor, development of iron-deficiency anemia, stomatitis, rashes (Duhring–Brocq dermatitis herpetiformis), delayed physical and mental development, impaired puberty, and other symptoms may be observed.

This panel has a dual purpose:

• reliably identifies individuals with gluten-sensitive enteropathy;
• allows monitoring of the effectiveness of and adherence to a gluten-free diet.

• Screening of patients with suspected celiac disease (positive family history).
• Screening of groups at increased risk of developing celiac disease (type 1 diabetes mellitus, Hashimoto’s autoimmune thyroiditis, systemic connective tissue diseases, and Down, Turner, and Williams syndromes).
• Sample collection before small intestinal biopsy.
• Assessment of the effectiveness of a gluten-free diet.

• Venous blood

In order to exclude factors that may affect the test results, we recommend to follow the preparation rules: