Abstract
The familial occurence of coeliac disease is well known. In every day practice, however, diagnosis of coeliac disease is not frequently established in the relatives of patients. As it did not seem practicable to biopsy all relatives, several tests were investigated in selecting individuals for intestinal biopsy in a family study. 55 index patients out of 54 families with biopsy-proven coeliac disease and 165 of their first grade relatives underwent the study. Immunofluorescent gliadin and reticulin antibodies were determined, and additionally laboratory tests were done. These included haemoglobin, serum iron, serum protein and albumin, serum immunoglobulins and blood xylose. The immunofluorescent gliadin antibody assay using red cells coated with gliadin proved to be superior to the other methods. False negatives came to 8.7%, and false positives 10.9%, in healthy relatives. Gliadin antibodies could be found five times more frequently in healthy relatives than in normal controls. This finding indicates a genetic predisposition to the formation of gliadin antibodies in coeliac families.
Ninety-one percent of index coeliac children had IgG-antigliadin in their sera while on a normal diet. During gluten-free diet, and in adult patients, results were less convincing. All relatives with antigliadin titres greater than 8 have been biopsied, and all with titres above 64 were shown to have coeliac disease. The prevalence of coeliac disease found in this study was 5.5%. In the active state of coeliac disease in children, gliadin antibody determination thus is a valuable diagnostic tool but in selecting relatives for biopsy there are limitations to the wide application of the test. Although reticulin antibodies are more specific for coeliac disease than gliadin antibodies, determination of antireticulin proved to be much less sensitive.
Similar content being viewed by others
References
Asquith P (1974) Family studies in coeliac disease. In: Coeliac disease, Hekkens WThJM, Pena AS (eds.). Stenfert Kroese, Leiden, pp 322–329
Carter C, Sheldon W, Walker C (1959) The inheritance of coeliac disease. Ann Hum Genet 23:266–273
David TJ, Ajdukiewicz AB (1975) A family study of coeliac disease. J Med Genet 12:79–82
Dennis NR, Stokes CR (1978) Risk of coeliac disease in children of patients and effect of HLA genotype. J Med Genet 15:20–22
Eade OE, Lloyd RS, Lang C, Wright R (1977) IgA and IgG reticulin antibodies in coeliac and non-coeliac patients. Gut 18:991–993
Ebbs JH (1956) Coeliac disease. Can Med A J 75:885–893
Eterman KP, Feltkamp TEW (1978) Antibodies to gluten and reticulin in gastrointestinal diseases. Clin Exp Immunol 31: 92–99
Falchuk ZM, Katz AJ, Shwachman H, Rogentine GN, Strober W (1978) Gluten-sensitive enteropathy: genetic analysis and organ culture study in 35 families. Scand J Gastroenterol 13:839–843
Ferguson A (1976) Celiac disease and gastrointestinal food allergy. In: Immunological aspects of the liver and gastro-intestinal tract, Ferguson A, MacSween RNM (eds). MTP Lancaster, pp 153–202
Governa M, Franchini I, Cella GD, Durand P (1973) Serum anti-reticulin antibody as further evidence of the increased immune response to dietary antigens in coeliac children. Helv Paediatr Acta 28:267–273
Hoffman HN, Wollaeger EE, Greenberg E (1966) Discordance for nontropical sprue (adult celiac disease) in a monozygotic twin pair. Gastroenterology 51:36–42
Little TM (1972) Immunoglobulin levels in families with coeliac disease. Lancet I:400–401
McCarthy CF, Mylotte M, Stevens F, Egan-Mitchell B, Fottrell PF, McNicholl B (1974) Family studies on coeliac disease in Ireland. In: Coeliac disease, Hekkens WThJM, Pena AS (eds). Stenfert Kroese, Leiden, pp 311–319
McCrae WM (1970) The inheritance of coeliac disease. In: Coeliac disease, Booth CC, Dowling RH (eds). Churchill Livingstone, London, pp 55–63
MacDonald WC, Dobbins WO, Rubin CE (1965) Studies of the familial nature of celiac sprue using biopsy of the small intestine. N Eng J Med 272:448–456
Magalhaes AFN, Peters TJ, Doe WF (1974) Studies on the nature and significance of connective tissue antibodies in adult coeliac disease and Crohn's disease. Gut 15:284–288
Mallas EG, Williamson N, Cooper BT, Cooke WT (1977) IgA class reticulin antibodies in relatives of patients with coeliac disease. Gut 18:647–650
Mylotte M, Egan-Mitchell B, Fottrell PF, McNicholl B, McCarthy CF (1974) Family studies in coeliac disease. Quart J Med 43:359–369
Pena AS, Mann DL, Hague NE, Heck JA, van Leeuwen A, van Rood JJ, Strober W (1978) Genetic basis of glutensensitive enteropathy. Gastroenterology 75:230–235
Penna FJ, Mota JAC, Roquete MLV, de Carvalho AST, de Oliveira Lemos AT, Barbosa AJA, Leao E, Ferreira RA, de Paula Castro L (1979) Coeliac disease in identical twins. Arch Dis Child 54:395–397
Polanco I, Vazquez C, Guerrero J, Carrasco S, Prieto G, Pena AS (1979) Concordance and discordance of coeliac disease in monozygotic twins. Acta Paediatr Belg 32:152–153
Rizzetto M, Doniach D (1973) Types of reticulin antibodies detected in human serum by immunofluorescence. J Clin Pathol 26:841–851
Robinson DC, Watson AJ, Wyatt EH, Marks JM, Roberts DF (1971) Incidence of small-intestinal mucosal abnormalities and of clinical coeliac disease in the relatives of children with coeliac disease. Gut 12:789–793
Rolles CJ, Kyaw-Myint TO, Sin WK (1974) Family study of coeliac disease. In: Coeliac disease, Hekkens WThJM, Pena AS (eds). Stenfert Kroese, Leiden, pp 320–321
Rosekrans PCM, Pena AS, Hekkens WThJM, de Vries RRP, Haex AJCh (1978) Coeliac disease. A family study in the Netherlands. In: Perspecitives in coeliac disease, McNicholl B, McCarthy CF, Fottrell PF (eds). MTP, Lancaster, pp 147–154
Rotthauwe HW, Sennekamp J, Emons D, Becker M (1976) Antiretikulin-Antikörper und präcipitierende Antikörper gegen Nahrungsmittelproteine im Serum von Kindern mit Cöliakie. Eur J Pediatr 121:215–226
Seah PP, Fry L, Hoffbrand AV, Holborow EJ (1971) Tissue antibodies in dermatitis herpetiformis and adult coeliac disease. Lancet I:834–836
Seah PP, Fry L, Rossiter MA, Hoffbrand AV, Holborow EJ (1971) Antireticulin antibodies in childhood coeliac disease. Lancet II:681–682
Stern M, Fischer K, Grüttner R (1979) Immunofluorescent serum gliadin antibodies in children with coeliac disease and various malabsorptive disorders. I. Technique, clinical evaluation and diagnostic use of a gliadin antibody assay using pyruvic aldehyde-treated human red cells. Eur J Pediatr 130: 155–164
Stern M, Bender SW (1979) Immunofluorescent gliadin antibodies in a family study of coeliac disease. Acta Paediatr Belg 32:148–149
Stevens FM, Lloyd R, Egan-Mitchell B, Mylotte MJ, Fottrell PF, Wright R, McNicholl B, McCarthy CF (1975) Reticulin antibodies in patients with coeliac disease and their relatives. Gut 16:598–602
Stokes PL, Asquith P, Cooke WT (1973) Genetics of coeliac disease. Clin Gastroenterol 2 (3):547–556
Stokes PL, Ferguson R, Holmes GKT, Cooke WT (1976) Familial aspects of coeliac disease. Quart J Med 45:567–582
Stokes PL, Prior P, Sorahan TM, McWalter RJ, Waterhouse JAH, Cooke WT (1976) Malignancy in relatives of patients with coeliac disease. Brit J Prev Soc Med 30:17–21
Walker-Smith JA (1973) Discordance for childhood coeliac disease in monozygotic twins. Gut 14:374–375
Author information
Authors and Affiliations
Additional information
Supported by Deutsche Forschungsgemeinschaft Gr 278/6 and Ste 305/1
Rights and permissions
About this article
Cite this article
Stern, M., Bender, S.W., Grüttner, R. et al. Serum antibodies against gliadin and reticulin in a family study of coeliac disease. Eur J Pediatr 135, 31–36 (1980). https://doi.org/10.1007/BF00445889
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00445889