Falsely elevated anti-tissue transglutaminase antibodies in patients with immunoproliferative small intestinal diseases: A case series.

Abstract

Immunoproliferative small intestinal disease (IPSID) is an uncommon disease of the smallintestine. There is a similarity in the clinical presentations of enteropathic diseases, includingceliac disease, tropical sprue, IPSID, and Whipple's disease. A differentiation between them isbased on the use of a highly specific serological test for celiac disease and specific histologicalcharacteristics. We found that IgA-anti-tissue transglutaminase antibody (IgA-tTG Ab) is falselyelevated in a subset of patients with IPSID. The levels of IgA-tTG Ab fall with the treatment ofIPSID. The healthcare professional should be aware of the conditions that lead to a false-positiveanti-tTG Ab. Intestinal mucosal biopsies even in the presence of anti-tTG Ab should be done inendemic regions as they provide an opportunity for making a diagnosis of alternative anduncommon diseases before the diagnosis of celiac disease.