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Updated: Jul 9, 2026
Recognition of Epidermal Transglutaminase by IgA and Tissue Transglutaminase 2 Antibodies in a Rare Case of Rhesus Dermatitis
Published on: December 15, 2011
Double immunohistochemistry to detect transglutaminase 2-IgA deposits in celiac children: a multicentre study
Carla Giordano1, Monica Montuori2, Paola Parente3
1Department of Radiology, Oncology and Pathology, Sapienza University of Rome, Roma, Italy.
Background:
Intestinal transglutaminase 2 (TGM2)-IgA deposits represent an early marker of celiac disease (CeD).
Objective:
This multicentre retrospective study aimed to assess the usefulness of a double immunohistochemistry technique for detecting TGM2-IgA deposits in formalin-fixed, paraffin-embedded duodenal biopsies from patients with CeD.
Methods:
Duodenal biopsy sections were classified into: i) CeD, characterized by villous atrophy and serum TGM2 antibodies of IgA class (TGA-IgA) levels categorized as <5 × ULN (low), 5-10 × ULN (moderate), or >10 × ULN (high); ii) Potential CeD (pCeD), defined by normal mucosa with persistently positive TGA-IgA <10 × ULN; iii) Controls, with normal histology and no organic disease. A small cohort of CeD patients was analysed both at diagnosis and after a gluten-free diet.
Results:
Double immunohistochemistry was performed on 166 CeD, 80 pCeD, and 80 control biopsies. TGM2-IgA deposits were identified in 100% of CeD cases, 72% of pCeD (Marsh 0/1) cases, and in none of the controls. Among 17 CeD patients re-evaluated after a gluten-free diet, all achieved mucosal healing (Marsh 0), 65% showed complete disappearance of deposits, and the remainder a marked reduction.
Conclusions:
TGM2-IgA double immunohistochemistry may help to refine diagnostic algorithms for CeD diagnosis.
