Abstract
Diagnostic Accuracy of IGA Anti-Tissue Transglutaminase Antibody Testing in Celiac DiseaseContemporary guidelines for the first-line diagnosis of celiac disease recommend determination of IgA anti-tissue transglutaminase antibodies or IgA antiendomysial antibodies, as well as total serum IgA antibodies. The aim of our study was to assess the validity and clinical significance of serological testing for IgA anti-tissue transglutaminase antibodies in the diagnosis of celiac disease, and to investigate the presence of malabsorption symptoms in celiac patients. IgA anti-tissue transglutaminase antibody testing was performed in 50 subjects with clinically suspected celiac disease (21 men and 29 women). All subjects underwent endoscopy with small intestine biopsy. Celiac disease was confirmed by histopathological findings in four subjects, whereas the IgA anti-tissue transglutaminase test was positive in three subjects. The IgA anti-tissue transglutaminase test showed sensitivity of 75% and specificity of 100%. There were significant differences between men with biopsy-confirmed and excluded celiac disease in the erythrocyte parameters MCV (96.5±7.7 vs. 78.6 ±11.3; p<0.05), MCH (36.9±4.6 vs. 25.9±4.9; p<0.01), and MCHC (382.5±16.3 vs. 326.9±19.1; p<0.005), as well as in the levels of total protein (47.5 ±16.3 vs. 68.3 ± 7.6; p<0.01) and albumins (24.6±9.5 vs. 42.1 ± 6.9; p<0.01). In addition, HDL-cholesterol levels were significantly lower in men with biopsy-confirmed celiac disease (0.42.±0.12 vs. 0.90±0.30; p<0.05). Our results show a high correlation between IgA anti-tissue transglutaminase testing and endoscopy with biopsy as the gold diagnostic standard.
Highlights
Celiac disease, or gluten-sensitive enteropathy, is a chronic inflammatory autoimmune disease caused by ingesting foods that contain gluten, in genetically predisposed persons [1]
The aim of our study was to assess the validity and clinical significance of serological testing for IgA anti-tissue transglutaminase antibodies in the diagnosis of celiac disease, and to investigate the presence of malabsorption symptoms in celiac patients
IgA anti-tissue transglutaminase antibody testing was performed in 50 subjects with clinically suspected celiac disease (21 men and 29 women)
Summary
Gluten-sensitive enteropathy, is a chronic inflammatory autoimmune disease caused by ingesting foods that contain gluten, in genetically predisposed persons [1]. Strong genetic susceptibility to celiac disease was suggested in a study with monozygotic twins, where celiac disease was found in both twins in 75% of cases [2]. Celiac disease is inherited by a two-locus double-recessive model, with the two loci being associated with certain histocompatibility antigens (HLA-DQ/DQ8) [3]. It was formerly regarded a rare childhood disorder, it is estimated to affect one in 100 individuals in the USA and other parts of the world [4]. Women are affected three times more often than men [4, 6]
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