06/10/2025
π©Ί Celiac Disease (Celiac Sprue) β Explanation
Celiac disease is an autoimmune disorder that occurs when the body reacts abnormally to gluten a protein found in certain grains such as wheat, barley, and rye.
When a person with celiac disease eats food containing gluten, their immune system becomes hypersensitive to a part of gluten called gliadin.
This immune reaction causes inflammation and damage to the lining of the small intestine β particularly the villi, which are responsible for absorbing nutrients.
As a result, patients often suffer from malabsorption, diarrhea, bloating, and nutrient deficiencies.
π¬ Laboratory Findings
To confirm the diagnosis, several antibody tests are used. These detect immune proteins that the body produces in response to gluten:
1. Tissue Transglutaminase Antibody (tTG-IgA, tTG-IgG)
This is the most sensitive and specific test for celiac disease.
The enzyme tissue transglutaminase (tTG) is the main target of the autoimmune reaction in celiac disease.
IgA is preferred for testing; however, if the patient has IgA deficiency, the IgG form can be used.
2. Endomysial Antibody (EMA-IgA)
Found in the connective tissue around smooth muscle fibers.
Highly specific β a positive result almost always indicates celiac disease.
Often used to confirm results of the tTG test.
3. Antigliadin Antibody (AGA-IgA, AGA-IgG)
These antibodies are directed against gliadin, part of the gluten protein.
Older test β not as accurate as tTG or EMA, but still useful, especially in young children or IgA-deficient patients.
βοΈ In short:
Celiac disease = autoimmune hypersensitivity to gluten β intestinal damage.
Diagnosis = tTG-IgA (best test) Β± EMA-IgA confirmation.
Management = strict lifelong gluten-free diet.