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The following paper was recently published.  I thought it might be of
interest to the participants of this list. The abstract has been reproduced
below. If interested, contact me for a copy at [log in to unmask]
 
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Celiac Disease and Hypoparathyroidism:  Cross-Reaction of
Endomysial Antibodies with Parathyroid Tissue
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Vijay Kumar (1,2), J.E. Valeski (1,2) and Jacobo Wortsman (3)
 
IMMCO Diagnostics, Inc.,1 Departments of Microbiology and Dermatology, State
University of New York at Buffalo,2 Buffalo, New York, and Department of
Internal Medicine, School of Medicine, Southern Illinois University,
Springfield, Illinois3
 
 
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
a 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.
 
Clinical and Diagnostic Immunology.  1996; 3:143-146.
 
 
Kevin Lawson
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