Tissue Transglutaminase Antibody and Its Association with Duodenal Biopsy in Diagnosis of Pediatric Celiac Disease
10.5223/pghn.2019.22.4.350
- Author:
Daleep K MEENA
1
;
Shalini AKUNURI
;
Preetam MEENA
;
Ashok BHRAMER
;
Shiv D SHARMA
;
Rajkumar GUPTA
Author Information
1. Pediatric Intensive Care Unit, Great Ormond Street Hospital, London, United Kingdom. akunurishalini@gmail.com
- Publication Type:Original Article
- Keywords:
Duodenitis;
Celiac disease;
Transglutaminase;
Antibodies
- MeSH:
Antibodies;
Biopsy;
Celiac Disease;
Child;
Diagnosis;
Diagnostic Tests, Routine;
Duodenitis;
Gastroenterology;
Humans;
Immunoglobulins;
Judgment;
Observational Study;
ROC Curve;
Sensitivity and Specificity;
Tertiary Care Centers;
Wetlands
- From:Pediatric Gastroenterology, Hepatology & Nutrition
2019;22(4):350-357
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: This study aimed to evaluate a possible association between the anti-tissue transglutaminase antibody (anti-tTG) titer and stage of duodenal mucosal damage and assess a possible cut-off value of anti-tTG at which celiac disease (CD) may be diagnosed in children in conjunction with clinical judgment. METHODS: This observational study was conducted at a gastroenterology clinic in a tertiary hospital from April 2012 to May 2013. Seventy children between 6-months and 18-years-old with suspected CD underwent celiac serology and duodenal biopsy. Statistical analyses were done using SPSS 16. Diagnostic test values were determined for comparing the anti-tTG titer with duodenal biopsy. An analysis of variance and Tukey-Kramer tests were performed for comparing the means between groups. A receiver operating characteristics curve was plotted to determine various cut-off values of anti-tTG. RESULTS: The mean antibody titer increased with severity of Marsh staging (p<0.001). An immunoglobulin (Ig) A-tTG value at 115 AU/mL had 76% sensitivity and 100% specificity with a 100% positive predictive value (PPV) and 17% negative predictive value (NPV) for diagnosis of CD (p<0.001, 95% confidence interval [CI], 0.75–1). CONCLUSION: There is an association between the anti-tTG titer and stage of duodenal mucosal injury in children with CD. An anti-tTG value of 115 AU/mL (6.4 times the upper normal limit) had 76% sensitivity, 100% specificity, with a 100% PPV, and 17% NPV for diagnosing CD (95% CI, 0.75–1). This cut-off may be used in combination with clinical judgment to diagnose CD.
