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Correlation of duodenal histology with tissue transglutaminase and endomysial antibody levels in pediatric celiac disease.
Clin Gastroenterol Hepatol 2007; 5(5):567-73CG

Abstract

BACKGROUND & AIMS

IgA antibodies against tissue transglutaminase (TTGA) and endomysium (EMA) are sensitive and specific markers for celiac disease (CD). Data correlating TTGA and EMA levels with degree of villous atrophy are limited. We compared duodenal histopathology in pediatric CD patients with TTGA and EMA serologies, symptoms, height, and weight.

METHODS

We identified 117 pediatric patients retrospectively who had serologic testing for IgA TTGA and IgA EMA and duodenal biopsies graded by modified Marsh criteria as 0-3c. Data were analyzed with Spearman rank correlation and multinomial logistic regression.

RESULTS

IgA TTGA (r = .704, P < .001) and IgA EMA (r = 0.740, P < .001) correlated with intestinal villous atrophy in pediatric CD patients by Spearman rank correlation. Similar correlations were found in a subset of 23 patients younger than 3 years of age. Multinomial logistic regression revealed increased probability of Marsh 3a or greater changes with increasing TTGA or EMA levels. Strongly positive antibody levels (TTGA >100 units or EMA titer >1:1280) were highly specific (>98%) for Marsh 3a or greater lesions. Among symptoms, abdominal distention and diarrhea were associated with abnormal histology.

CONCLUSIONS

IgA TTGA and EMA levels correlate with duodenal villous atrophy in pediatric CD patients. IgA TTGA >100 or EMA >1:1280 were nearly always associated with CD histopathology. With further validation of this observation, strongly positive titers might be considered sufficient for diagnosis of pediatric patients at risk for CD. Symptoms, height, and weight are not reliable predictors of CD.

Authors+Show Affiliations

Department of Dermatology, University of Utah, Salt Lake City, Utah, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

17428743

Citation

Donaldson, Matthew R., et al. "Correlation of Duodenal Histology With Tissue Transglutaminase and Endomysial Antibody Levels in Pediatric Celiac Disease." Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, vol. 5, no. 5, 2007, pp. 567-73.
Donaldson MR, Firth SD, Wimpee H, et al. Correlation of duodenal histology with tissue transglutaminase and endomysial antibody levels in pediatric celiac disease. Clin Gastroenterol Hepatol. 2007;5(5):567-73.
Donaldson, M. R., Firth, S. D., Wimpee, H., Leiferman, K. M., Zone, J. J., Horsley, W., ... Book, L. S. (2007). Correlation of duodenal histology with tissue transglutaminase and endomysial antibody levels in pediatric celiac disease. Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, 5(5), pp. 567-73.
Donaldson MR, et al. Correlation of Duodenal Histology With Tissue Transglutaminase and Endomysial Antibody Levels in Pediatric Celiac Disease. Clin Gastroenterol Hepatol. 2007;5(5):567-73. PubMed PMID: 17428743.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Correlation of duodenal histology with tissue transglutaminase and endomysial antibody levels in pediatric celiac disease. AU - Donaldson,Matthew R, AU - Firth,Sean D, AU - Wimpee,Holly, AU - Leiferman,Kristin M, AU - Zone,John J, AU - Horsley,Wyatt, AU - O'Gorman,Molly A, AU - Jackson,W Daniel, AU - Neuhausen,Susan L, AU - Hull,Christopher M, AU - Book,Linda S, Y1 - 2007/04/11/ PY - 2007/4/13/pubmed PY - 2007/12/14/medline PY - 2007/4/13/entrez SP - 567 EP - 73 JF - Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association JO - Clin. Gastroenterol. Hepatol. VL - 5 IS - 5 N2 - BACKGROUND & AIMS: IgA antibodies against tissue transglutaminase (TTGA) and endomysium (EMA) are sensitive and specific markers for celiac disease (CD). Data correlating TTGA and EMA levels with degree of villous atrophy are limited. We compared duodenal histopathology in pediatric CD patients with TTGA and EMA serologies, symptoms, height, and weight. METHODS: We identified 117 pediatric patients retrospectively who had serologic testing for IgA TTGA and IgA EMA and duodenal biopsies graded by modified Marsh criteria as 0-3c. Data were analyzed with Spearman rank correlation and multinomial logistic regression. RESULTS: IgA TTGA (r = .704, P < .001) and IgA EMA (r = 0.740, P < .001) correlated with intestinal villous atrophy in pediatric CD patients by Spearman rank correlation. Similar correlations were found in a subset of 23 patients younger than 3 years of age. Multinomial logistic regression revealed increased probability of Marsh 3a or greater changes with increasing TTGA or EMA levels. Strongly positive antibody levels (TTGA >100 units or EMA titer >1:1280) were highly specific (>98%) for Marsh 3a or greater lesions. Among symptoms, abdominal distention and diarrhea were associated with abnormal histology. CONCLUSIONS: IgA TTGA and EMA levels correlate with duodenal villous atrophy in pediatric CD patients. IgA TTGA >100 or EMA >1:1280 were nearly always associated with CD histopathology. With further validation of this observation, strongly positive titers might be considered sufficient for diagnosis of pediatric patients at risk for CD. Symptoms, height, and weight are not reliable predictors of CD. SN - 1542-7714 UR - https://www.unboundmedicine.com/medline/citation/17428743/Correlation_of_duodenal_histology_with_tissue_transglutaminase_and_endomysial_antibody_levels_in_pediatric_celiac_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1542-3565(07)00061-4 DB - PRIME DP - Unbound Medicine ER -