Determination of Diagnostic Accuracy of Anti Endomyseal Antibodies Detection by Indirect Immunofluorescence Using Human Umbilical Cord as a Substrate

Hina Mushtaq; Hamid Nawaz Tipu; Muhammad Hussain; Mariam Bibi; Muhammad  Aftab Hassan; Imran   Khan

doi:10.51253/pafmj.v76iSUPPL-6.14203

Authors

Hina Mushtaq Department of Hematology, E Shifa International, Stat Lab, Peshawar Pakistan
Hamid Nawaz Tipu Department of Immunology, Armed Forces Institute of Pathology, Rawalpindi/ National University of Medical Sciences (NUMS) Pakistan
Muhammad Hussain Department of Immunology, Combined Military Hospital, Lahore/National University of Medical Sciences (NUMS) Pakistan
Mariam Bibi Department of Immunology, Armed Forces Institute of Pathology, Rawalpindi/ National University of Medical Sciences (NUMS) Pakistan
Muhammad Aftab Hassan Department of Immunology, Combined Military Hospital, Loralai/National University of Medical Sciences (NUMS) Pakistan
Imran Khan Department of Medicine, Combined Military Hospital, Peshawar/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76iSUPPL-6.14203

Keywords:

Anti-Endomyseal Antibodies; Autoimmune Enteropathy; Celiac Disease; Diagnostic Accuracy; Human Umbilical Cord; Indirect Immunofluorescence; Primate Esophagus; Serologic Tests

Abstract

Objective: To evaluate the diagnostic accuracy of anti-endomyseal antibody (EMA) detection using indirect immunofluorescence (IIF) on human umbilical cord (HUC) substrate, compared with biopsy-confirmed celiac disease (CD), and to assess its agreement with the conventional primate esophagus (PE) substrate.

Study Design: Comparative cross-sectional study.

Place and Duration of Study: Department of Immunology, Armed Forces Institute of Pathology, Rawalpindi, Pakistan conducted from Jun 2024 to Mar 2025.

Methodology: In this study 86 cases who were diagnosed as Celiac disease on duodenal biopsy, and 90 age matched controls were included. The control group included 40 paderaites patients, 40 healthy blood donor population and 10 patients with Hypertension. IgA deficiency was ruled out in all the patients. IIF was performed on both the cases and controls sample on both commercial slides with Primate esophagus and on in house using Human umbilical cord as a substrate respectively.

Result: The Sensitivity and Specificity of HUC for the detection of anti endomyseal antibodies came out to be 96.5% and 97.8% respectively. The Positive predictive value, Negative predictive value and diagnostic accuracy were 97.6%, 96.7% and 97.1% respectively. Agreement between HUC-EMA and PE-EMA was excellent, with perfect inter-observer concordance (κ = 1.00)

Conclusion: In house HUC is an excellent substrate for detection of Anti endomyseal antibodies.It can serve as a reliable alternate to the commercial slides using primate oesophagus in terms of sensitivity and specificity. Moreover, it is inexpensive, and readily available.

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Author Biography

Hina Mushtaq, Department of Hematology, E Shifa International, Stat Lab, Peshawar Pakistan

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