IgA antibodies against tissue transglutaminase, endomysium and gliadin in idiopathic polyneuropathy

Authors

  • M. Vrethem,

    Corresponding author
    1. Division of Neurophysiology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden
    2. Department of Neurology and Neurophysiology, County Council of Östergötland, Linköping, Sweden
    • Division of Neurology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden
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    • Has contributed equally to the study.
  • J. Lindh,

    1. Section of Neurology, Department of Internal Medicine, Ryhov County Hospital, Jönköping, Sweden
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    • Has contributed equally to the study.
  • M. Tondel,

    1. Occupational and Environmental Medicine, Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
    2. Division of Occupational and Environmental Medicine, Department of Health and Environment, Linköping University, Linköping, Sweden
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  • B. Persson,

    1. Occupational and Environmental Medicine, Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
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  • C. Dahle

    1. Division of Clinical Immunology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden
    2. Department of Clinical Immunology and Transfusion Medicine, County Council of Östergötland, Linköping, Sweden
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M. Vrethem, Department of Neurology, Linkping University Hospital, S-581 85 Linkping, Sweden

Tel.: +46101032048

Fax: +46101034438

e-mail: magnus.vrethem@lio.se.

Abstract

Objectives

To study the prevalence of antibodies of IgA class against tissue transglutaminase (tTG), endomysium (EMA) and gliadin (AGA) in patients with chronic idiopathic axonal polyneuropathy (CIAP) and to characterize the patients clinically and neurophysiologically.

Methods

Of 182 patients, 126 patients agreed to blood sampling. Sera were analysed by ELISAs detecting anti-tTG and AGA, whereas EMA was analysed by indirect immunofluorescence (IF) microscopy. Gastrointestinal symptoms were assessed by data from medical records and patient interviews.

Results

Nine of 126 patients (7%) were seropositive in at least one test (five with positive anti-tTG and/or EMA and four with positive AGA only). One patient with elevated levels of all specificities had laboratory signs of malabsorption and gastrointestinal complaints with abdominal pain and diarrhoea.

Conclusions

Elevated levels of IgA-AGA were slightly more frequent in patients with CIAP (4%) compared to 2.5% in 1866 healthy blood donors. Highly specific serological markers indicative of coeliac disease (CD) (anti-tTG and EMA) were somewhat more common in our patients with CIAP (4%) than expected from normal reference values and from studies of the prevalence of CD in the general population. Even though these findings may indicate a relationship, the aetiological importance is unclear.

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