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Clinical and Diagnostic Laboratory Immunology, 03 1996, 143-146, Vol 3, No. 2
V Kumar, JE Valeski and J Wortsman
Celiac disease (CD) is a gluten-sensitive enteropathy characterized by the
presence of serum antibodies to endomysial reticulin and gliadin antigens.
CD has been associated with various autoimmune endocrine disorders, such as
diabetes. We report a rare case of idiopathic hypoparathyroidism with
coexistent CD characterized by the presence of serum autoantibodies.
Studies were conducted to determine the specificities of these
autoantibodies and to localize the antibody binding sites by indirect
immunofluorescence and immunoelectron microscopy. Sera from a patient with
idiopathic hypoparathyroidism and CD and from two patients with CD alone
were tested by indirect immunofluorescence for autoantibodies to
parathyroid and endomysial antigens. The specificities of the antibody
reactions were determined by testing the sera before and after absorption
with monkey stomach tissue. In addition, immunoelectron microscopic studies
were performed to determine the localization of the endomysial antigen.
Indirect- immunofluorescence studies on the patient's serum were positive
with the parathyroid as well as the endomysial substrate. Similar reactions
were also observed with the sera of endomysial antibody-positive patients
with CD. Absorption of the sera with monkey stomach powder, which is known
to have the endomysial antigen, abolished the antibody activities on both
the endomysial substrate and the parathyroid tissue. Immunoelectron
microscopic studies showed that endomysial antibody activity was associated
with antigens localized on the myocyte plasma membrane and in the
intercellular spaces. Thus, reactions of the patient's serum with the
parathyroid tissue were due to endomysial antibodies and were not
parathyroid specific as in patients with idiopathic hypoparathyroidism who
did not have coexistent CD. In conclusion, indirect-immunofluorescence
tests on parathyroid tissue detect not only tissue-specific antibodies but
also cross-reactive antibodies, and this should be taken into consideration
when these tests are performed.
Copyright © 1996 by the American Society for Microbiology. All rights reserved.
Celiac disease and hypoparathyroidism: cross-reaction of endomysial antibodies with parathyroid tissue
IMMCO Diagnostics, Inc., Buffalo, NY 14223, USA.
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