ArticleJournal of clinical laboratory analysis2018
Hemolysis and IgA-antibodies against tissue transglutaminase: When are antibody test results no longer reliable?
Article in Journal of clinical laboratory analysis, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed, 6 citations in OpenAlex.
- Hemolysis and IgA-antibodies against tissue transglutaminase: When are antibody test results no longer reliable?Journal of clinical laboratory analysis · 2018Article
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6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAntibodies against tissue transglutaminase (TTG) of isotype IgA (IgA-aTTG) represent reliable diagnostic markers to confirm or exclude celiac disease (CD). Hemolysis (HL) is an important pre-analytical factor. HL can be quantified as HL index (HI) correlating with the concentration of free hemoglobin. TTG is abundant in erythrocytes and released upon HL. In immunoassays, the released TTG may interfere with binding of IgA-aTTG to the coated TTG.
methodsWe selected 17 HL-free sera from children with biopsy-confirmed CD: 7 with low-positive (1-5 multiples of upper limit of normal [×ULN]), 5 with intermediate (5-10 × ULN) and 5 with high IgA-aTTG (10-15 × ULN). Sera were spiked with hemolysates resulting in HIs ranging from 12.5 to 800 (12.5-800 mg/dL free hemoglobin).
resultsIgA-aTTG values were significantly decreased (>10%) after addition of hemolysates even if HL was invisible (HI <50). This effect is diagnosis-relevant if IgA-aTTG values are measured just below the cut-offs: (i) 0.4-1 × ULN at HI ≥25 (CD not excludable) and (ii) 8.5-10 × ULN at HI ≥200 (diagnosis of CD without biopsy not possible). Antibodies against deamidated gliadin were not influenced by HL.
conclusionsIgA-aTTG results in sera with HI ≥25 can yield inconclusive results. Therefore, those antibody results should be assessed only under consideration of the HI.
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