Usefulness of a double immunofluorescence technique for detection of intestinal tTG-IgA deposits in diabetic and non-diabetic children with celiac disease

Background: Celiac disease (CD) is frequently associated with type I diabetes mellitus (T1D), where its diagnosis may be a challenging task. This study aims to test the usefulness of the double staining immunofluorescence (dsIF) technique for the detection of intestinal anti-tissue transglutaminase...

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Main Authors: Raghav Lal, Ranjeet Bhardwaj, Ranjana Walker Minz, Kaushal Kishore Prasad, Sadhna Lal, Devi Dayal, Yashwant Kumar
Format: Article
Language:English
Published: Elsevier 2023-07-01
Series:Pediatrics and Neonatology
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Online Access:http://www.sciencedirect.com/science/article/pii/S1875957222002698
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author Raghav Lal
Ranjeet Bhardwaj
Ranjana Walker Minz
Kaushal Kishore Prasad
Sadhna Lal
Devi Dayal
Yashwant Kumar
author_facet Raghav Lal
Ranjeet Bhardwaj
Ranjana Walker Minz
Kaushal Kishore Prasad
Sadhna Lal
Devi Dayal
Yashwant Kumar
author_sort Raghav Lal
collection DOAJ
description Background: Celiac disease (CD) is frequently associated with type I diabetes mellitus (T1D), where its diagnosis may be a challenging task. This study aims to test the usefulness of the double staining immunofluorescence (dsIF) technique for the detection of intestinal anti-tissue transglutaminase specific IgA antibody (tTG-IgA) deposits in CD and T1D children with coexisting CD. Methods: A total of 46 patients (30 cases of CD and 16 cases of T1D with CD) and 16 non-diabetic, non-celiac children were recruited. Endoscopic biopsies were taken and analyzed by light microscopy, quantitative histology (QH), and a dsIF technique. Results: Histologically, villous atrophy was most severe in CD, followed by T1D with CD, while all control biopsies except 1 were normal. QH showed a statistically significant difference in villous height (Vh), crypt depth (CrD), and Vh:CrD ratio between diabetic and non-diabetic patients with CD. dsIF technique could detect tTG-IgA deposits in 85.7% of cases of CD alone and 93.8% of biopsies from diabetic children. Surprisingly, deposits were more extensive in biopsies with minimal villous shortening. Also, all 5 biopsies from T1D patients with normal histology were dsIF positive. Conclusion: In-situ analysis of tTG-IgA immune deposits facilitates the detection of positive serology early-onset CD. Quantitative analysis may be used as an ancillary tool to increase the reliability of histological findings in these patients.
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spelling doaj-art-bd77f6af5c03422b82331fb63ca8c58b2025-08-20T03:04:44ZengElsevierPediatrics and Neonatology1875-95722023-07-0164438839710.1016/j.pedneo.2022.01.012Usefulness of a double immunofluorescence technique for detection of intestinal tTG-IgA deposits in diabetic and non-diabetic children with celiac diseaseRaghav Lal0Ranjeet Bhardwaj1Ranjana Walker Minz2Kaushal Kishore Prasad3Sadhna Lal4Devi Dayal5Yashwant Kumar6Department of Immunopathology, Post Graduate Institute of Medical Education & Research, Chandigarh, IndiaDepartment of Immunopathology, Post Graduate Institute of Medical Education & Research, Chandigarh, IndiaDepartment of Immunopathology, Post Graduate Institute of Medical Education & Research, Chandigarh, IndiaDepartment of Gastroenterology, Post Graduate Institute of Medical Education & Research, Chandigarh, IndiaDepartment of Pediatric Gastroenterology, Post Graduate Institute of Medical Education & Research, Chandigarh, IndiaDepartment of Pediatric Endocrinology, Post Graduate Institute of Medical Education & Research, Chandigarh, IndiaDepartment of Immunopathology, Post Graduate Institute of Medical Education & Research, Chandigarh, India; Corresponding author. Department of Immunopathology, Post Graduate Institute of Medical Education & Research, Chandigarh, India.Background: Celiac disease (CD) is frequently associated with type I diabetes mellitus (T1D), where its diagnosis may be a challenging task. This study aims to test the usefulness of the double staining immunofluorescence (dsIF) technique for the detection of intestinal anti-tissue transglutaminase specific IgA antibody (tTG-IgA) deposits in CD and T1D children with coexisting CD. Methods: A total of 46 patients (30 cases of CD and 16 cases of T1D with CD) and 16 non-diabetic, non-celiac children were recruited. Endoscopic biopsies were taken and analyzed by light microscopy, quantitative histology (QH), and a dsIF technique. Results: Histologically, villous atrophy was most severe in CD, followed by T1D with CD, while all control biopsies except 1 were normal. QH showed a statistically significant difference in villous height (Vh), crypt depth (CrD), and Vh:CrD ratio between diabetic and non-diabetic patients with CD. dsIF technique could detect tTG-IgA deposits in 85.7% of cases of CD alone and 93.8% of biopsies from diabetic children. Surprisingly, deposits were more extensive in biopsies with minimal villous shortening. Also, all 5 biopsies from T1D patients with normal histology were dsIF positive. Conclusion: In-situ analysis of tTG-IgA immune deposits facilitates the detection of positive serology early-onset CD. Quantitative analysis may be used as an ancillary tool to increase the reliability of histological findings in these patients.http://www.sciencedirect.com/science/article/pii/S1875957222002698anti-tissue transglutaminase IgA antibodyceliac diseasedouble immunofluorescencequantitative histologytissue transglutaminasetype I diabetes Mellitus
spellingShingle Raghav Lal
Ranjeet Bhardwaj
Ranjana Walker Minz
Kaushal Kishore Prasad
Sadhna Lal
Devi Dayal
Yashwant Kumar
Usefulness of a double immunofluorescence technique for detection of intestinal tTG-IgA deposits in diabetic and non-diabetic children with celiac disease
Pediatrics and Neonatology
anti-tissue transglutaminase IgA antibody
celiac disease
double immunofluorescence
quantitative histology
tissue transglutaminase
type I diabetes Mellitus
title Usefulness of a double immunofluorescence technique for detection of intestinal tTG-IgA deposits in diabetic and non-diabetic children with celiac disease
title_full Usefulness of a double immunofluorescence technique for detection of intestinal tTG-IgA deposits in diabetic and non-diabetic children with celiac disease
title_fullStr Usefulness of a double immunofluorescence technique for detection of intestinal tTG-IgA deposits in diabetic and non-diabetic children with celiac disease
title_full_unstemmed Usefulness of a double immunofluorescence technique for detection of intestinal tTG-IgA deposits in diabetic and non-diabetic children with celiac disease
title_short Usefulness of a double immunofluorescence technique for detection of intestinal tTG-IgA deposits in diabetic and non-diabetic children with celiac disease
title_sort usefulness of a double immunofluorescence technique for detection of intestinal ttg iga deposits in diabetic and non diabetic children with celiac disease
topic anti-tissue transglutaminase IgA antibody
celiac disease
double immunofluorescence
quantitative histology
tissue transglutaminase
type I diabetes Mellitus
url http://www.sciencedirect.com/science/article/pii/S1875957222002698
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