Anti Enterocyte Autoantibodies in Pediatric Celiac Disease

Abstract

Many aspects are shared between celiac disease and autoimmune enteropathy: symptoms, diagnosis by serological bio-markers, endoscopic findings, intestinal pathology, differential diagnosis, and pharmaceutical therapy in selected cases. Antibodies to tissue transglutaminase have been described in over 30% of patients with autoimmune enteropathy, but no anti-enterocyte antibodies were detected in a small population of pediatric celiac patients. The aim of the current study was to identify anti-enterocyte antibodies in pediatric patients with well-characterized celiac disease compared to a group of children with recurrent abdominal pain. Materials and methods: celiac disease (N=38) was diagnosed based on positive celiac serology (anti-neoepitope tissue transglutaminase (Aesku*) and/or anti endomysial antibodies) and small intestinal biopsy that was consistent with celiac disease. The comparison group consisted of age and sex matched patients (N=41) with a history of abdominal pain, negative celiac serology, normal upper endoscopy and normal small intestinal histology. Detection of anti-enterocyte antibody was performed using Western blot. Homogenates from normal human intestinal mucosa were electrophoresed on 7.5% SDS-PAGE and transferred to nitrocellulose membranes. Blots were treated with blinded patient sera and developed using ELISA kit. Results: In the pediatric celiac group 3/35 (8.6%) compared to 6/35 (17.1%) in the non-celiac group were positive for anti-enterocyte antibody. No statistically significant difference in the presence of anti-enterocyte antibodies in patients with celiac disease. Conclusions: About 8% of children with celiac disease may have antibodies to enterocytes, but the frequency is not increased when compared to children with recurrent abdominal pain.