Antiendomysial and antihuman recombinant tissue transglutaminase antibodies in the diagnosis of coeliac disease: a biopsy-proven European multicentre study.

OBJECTIVE: To investigate the value of serum antitissue transglutaminase IgA antibodies (IgA-TTG) and IgA antiendomysial antibodies (IgA-EMA) in the diagnosis of coeliac disease in cohorts from different geographical areas in Europe. The setting allowed a further comparison between the antibody results and the conventional small-intestinal histology. METHODS: A total of 144 cases with coeliac disease [median age 19.5 years (range 0.9-81.4)], and 127 disease controls [median age 29.2 years (range 0.5-79.0)], were recruited, on the basis of biopsy, from 13 centres in nine countries. All biopsy specimens were re-evaluated and classified blindly a second time by two investigators. IgA-TTG were determined by ELISA with human recombinant antigen and IgA-EMA by an immunofluorescence test with human umbilical cord as antigen. RESULTS: The quality of the biopsy specimens was not acceptable in 29 (10.7%) of 271 cases and a reliable judgement could not be made, mainly due to poor orientation of the samples. The primary clinical diagnosis and the second classification of the biopsy specimens were divergent in nine cases, and one patient was initially enrolled in the wrong group. Thus, 126 coeliac patients and 106 controls, verified by biopsy, remained for final analysis. The sensitivity of IgA-TTG was 94% and IgA-EMA 89%, the specificity was 99% and 98%, respectively. CONCLUSIONS: Serum IgA-TTG measurement is effective and at least as good as IgA-EMA in the identification of coeliac disease. Due to a high percentage of poor histological specimens, the diagnosis of coeliac disease should not depend only on biopsy, but in addition the clinical picture and serology should be considered.

Stability Problems in Inverse Diffraction

Inverse diffraction consists in determining the field distribution on a boundary surface from the knowledge of the distribution on a surface situated within the domain where the wave propagates. This problem is a good example for illustrating the use of least-squares methods (also called regularization methods) for solving linear ill-posed inverse problem. We focus on obtaining error bounds For regularized solutions and show that the stability of the restored field far from the boundary surface is quite satisfactory: the error is proportional to ∊(ðŗ‚ ≃ 1) ,ðŗœ being the error in the data (Hölder continuity). However, the error in the restored field on the boundary surface is only proportional to an inverse power of │In∊│ (logarithmic continuity). Such a poor continuity implies some limitations on the resolution which is achievable in practice. In this case, the resolution limit is seen to be about half of the wavelength. Copyright © 1981 by The Institute of Electrical and Electronics Engineers, Inc.