IgA Tissue Transglutaminase 6 Antibodies (TTG6, TG6)

Immunology

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Description

Tissue transglutaminase 6 ( TG6 ) is expressed in a subset of neurons. The presence of TG6 antibodies has been described in patients with gluten ataxia and gluten neuropathy ( 1,2,3 ). Gluten ataxia usually presents with gait and lower limb ataxia. It has a mean age of onset of 53 years ( 4 ). Many patients also have evidence of enteropathy on duodenal biopsy. Originally IgA and IgG anti-gliadin antibodies were used to help in the investigation of the conditions. The discovery of TG6 antibodies has provided another marker which can be used to aid in diagnosis. Care should be taken when interpreting results as TG6 antibodies may also be present in other conditions and in healthy patients ( 4% ) ( 1,2,3 ). Compliance with a gluten free diet can significantly reduced the level of TG6 antibodies and clinical symptoms ( 1 ).

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Indications

Gluten associated ataxia. The tests should only be requested in patients with symptoms of ataxia.

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Sample Type

2mL Serum ( Gel 5mL Yellow tube ). Requests from outside Sheffield: Transport at ambient temperature via Royal Mail or Courier.

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Reference Range

<2.6 U/mL = Negative
2.6 - 4 U/mL = Equivocal
>4 U/mL = Positive

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Turnaround Time

Within 10 days

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Testing Frequency

2 weeks

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References

Hadjivassiliou M, Aeschlimann P, Sanders DS, et al. Transglutaminase 6 antibodies in the diagnosis of gluten ataxia. Neurology. 2013. 80( 19 ): 1740-1745. [Ref 1]
Yu XB, Uhde M, Green PH, et al. Autoantibodies in the extraintestinal manifestations of coeliac disease. Nutrients. 2018. 10( 8 ): 1123. [Ref 2].
Zis P, Rao DG, Sarrigiannis PG, et al. Transglutaminase 6 antibodies in gluten neuropathy. Dig Liver Dis. 2017. 49( 11 ):1196-1200. [Ref 3].
Hadjivassiliou M, Sanders DS, Aeschlimann DP. Gluten-related disorders: gluten ataxia. Dig Dis. 2015. 33( 2 ):264-268. [Ref 4].

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