{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T14:36:29Z","timestamp":1768314989802,"version":"3.49.0"},"reference-count":16,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,11,23]],"date-time":"2017-11-23T00:00:00Z","timestamp":1511395200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Laboratory Analysis"],"published-print":{"date-parts":[[2018,5]]},"abstract":"Background<\/jats:title>Antibodies against tissue transglutaminase (TTG<\/jats:styled-content>) of isotype IgA (IgA\u2010aTTG<\/jats:styled-content>) represent reliable diagnostic markers to confirm or exclude celiac disease (CD<\/jats:styled-content>). Hemolysis (HL<\/jats:styled-content>) is an important pre\u2010analytical factor. HL<\/jats:styled-content> can be quantified as HL index (HI<\/jats:styled-content>) correlating with the concentration of free hemoglobin. TTG<\/jats:styled-content> is abundant in erythrocytes and released upon HL<\/jats:styled-content>. In immunoassays, the released TTG<\/jats:styled-content> may interfere with binding of IgA\u2010aTTG<\/jats:styled-content> to the coated TTG.<\/jats:p><\/jats:sec>Methods<\/jats:title>We selected 17 HL<\/jats:styled-content>\u2010free sera from children with biopsy\u2010confirmed CD<\/jats:styled-content>: 7 with low\u2010positive (1\u20105 multiples of upper limit of normal [\u00d7ULN<\/jats:styled-content>]), 5 with intermediate (5\u201010\u00a0\u00d7\u00a0ULN) and 5 with high IgA\u2010aTTG (10\u201015\u00a0\u00d7\u00a0ULN). Sera were spiked with hemolysates resulting in HI<\/jats:styled-content>s ranging from 12.5 to 800 (12.5\u2010800\u00a0mg\/dL<\/jats:styled-content> free hemoglobin).<\/jats:p><\/jats:sec>Results<\/jats:title>IgA\u2010aTTG values were significantly decreased (>10%) after addition of hemolysates even if HL<\/jats:styled-content> was invisible (HI<\/jats:styled-content> <50). This effect is diagnosis\u2010relevant if IgA\u2010aTTG<\/jats:styled-content> values are measured just below the cut\u2010offs: (i) 0.4\u20101\u00a0\u00d7\u00a0ULN at HI<\/jats:styled-content> \u226525 (CD<\/jats:styled-content> not excludable) and (ii) 8.5\u201010\u00a0\u00d7\u00a0ULN at HI<\/jats:styled-content> \u2265200 (diagnosis of CD<\/jats:styled-content> without biopsy not possible). Antibodies against deamidated gliadin were not influenced by HL.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>IgA\u2010aTTG<\/jats:styled-content> results in sera with HI<\/jats:styled-content> \u226525 can yield inconclusive results. Therefore, those antibody results should be assessed only under consideration of the HI<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcla.22360","type":"journal-article","created":{"date-parts":[[2017,11,23]],"date-time":"2017-11-23T10:07:15Z","timestamp":1511431635000},"source":"Crossref","is-referenced-by-count":5,"title":["Hemolysis and IgA\u2010antibodies against tissue transglutaminase: When are antibody test results no longer reliable?"],"prefix":"10.1002","volume":"32","author":[{"given":"Johannes","family":"Wolf","sequence":"first","affiliation":[{"name":"Institute of Laboratory Medicine Clinical Chemistry and Molecular Diagnostics Medical Faculty of the University and University Hospital Leipzig Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norman","family":"Haendel","sequence":"additional","affiliation":[{"name":"University Children's Hospital Leipzig Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2598-3616","authenticated-orcid":false,"given":"Johannes","family":"Remmler","sequence":"additional","affiliation":[{"name":"Institute of Laboratory Medicine Clinical Chemistry and Molecular Diagnostics Medical Faculty of the University and University Hospital Leipzig Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carl Elias","family":"Kutzner","sequence":"additional","affiliation":[{"name":"Institute of Laboratory Medicine Clinical Chemistry and Molecular Diagnostics Medical Faculty of the University and University Hospital Leipzig Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thorsten","family":"Kaiser","sequence":"additional","affiliation":[{"name":"Institute of Laboratory Medicine Clinical Chemistry and Molecular Diagnostics Medical Faculty of the University and University Hospital Leipzig Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Mothes","sequence":"additional","affiliation":[{"name":"Institute of Laboratory Medicine Clinical Chemistry and Molecular Diagnostics Medical Faculty of the University and University Hospital Leipzig Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,11,23]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/nm0797-797"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra071600"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e31821a23d0"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2004.035832"},{"key":"e_1_2_8_6_1","doi-asserted-by":"crossref","first-page":"2142","DOI":"10.1093\/clinchem\/45.12.2142","article-title":"Recombinant human tissue transglutaminase ELISA for the diagnosis of gluten\u2010sensitive 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