JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY
Abstract
Background: Dermatitis Herpetiformis (DH) diagnosis relies on direct immunofluorescence (DIF)
on skin biopsy. Serology for anti-epidermal transglutaminase antibodies (Anti-TG3 Abs) has
attracted interest, being inexpensive and less invasive. However, the available test has variable
sensitivity and low specificity in Coeliac Disease (CD) patients without DH.
Objective: To evaluate the diagnostic accuracy and reproducibility of a novel quantitative ELISA
for the measurement of Anti-TG3 Abs.
Methods: ELISA was set-up with recombinant TG3 and a standard curve based on a human
recombinant monoclonal IgA anti-TG3. Sera of 57 DH patients, 212 CD patients, 120 patients with
non-gluten related gastrointestinal diseases (CTRL) and 168 healthy controls (HC) were tested.
Results: The test was reproducible with high sensitivity (91%). Test specificity was high when
considering HC (99%) as well as CTRL (98%). Interestingly in CD patients test specificity was agedependent
and was higher (97%) in patients ≤ 25 years of age.
Limitations: Not all DH were confirmed by DIF.
Conclusion: The ELISA test could be used as a screening tool when DH is clinically suspected
and may serve as a sole diagnostic test in younger patients. The quantification of Anti-TG3 Abs
levels will facilitate the comparison of results from different laboratories.
