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Strongly positive tissue transglutaminase antibodies are associated with Marsh 3 histopathology in adult and pediatric celiac disease.
J Clin Gastroenterol 2008; 42(3):256-60JC

Abstract

GOALS

Our objective was to determine whether high serologic IgA tissue transglutaminase antibodies (TTGA) are exclusively associated with celiac disease (CD).

BACKGROUND

IgA TTGA are found in the serum of most individuals with CD. This serologic marker is used to screen individuals with suspected CD for duodenal biopsy, the gold standard of CD diagnosis. Data suggest strongly positive IgA TTGA >or= 100 units are highly specific for CD histopathology in pediatric patients and may be sufficient for diagnosis.

STUDY

Records of adult and pediatric subjects in the celiac study at the University of Utah and University of California Irvine were reviewed for strongly positive TTGA. Pathology reports from duodenal biopsies of subjects with IgA TTGA >or= 100 units were graded as 0 to 3 by modified Marsh criteria.

RESULTS

From a pool of 1882 subjects with IgA TTGA assayed, 208 had IgA TTGA >or= 100 units. Seventy-six of these, including 28 children and 48 adults, also had duodenal biopsies. Villous atrophy (Marsh 3 histopathology) was found on biopsy in 73 (96%) of these subjects. The remaining 3 subjects had intermediate Marsh histology. One (Marsh 1) had a complete serologic response to a gluten-free diet and 2 had Marsh 2 lesions and positive endomysium, making early CD most likely.

CONCLUSIONS

IgA TTGA >or= 100 units occur almost exclusively in the setting of Marsh 3 duodenal histopathology in adults and children. Rare cases without villous atrophy were marked by intermediate Marsh changes suggestive of early CD. IgA TTGA >or= 100 arbitrary units indicate duodenal changes consistent with CD.

Authors+Show Affiliations

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

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

18223500

Citation

Donaldson, Matthew R., et al. "Strongly Positive Tissue Transglutaminase Antibodies Are Associated With Marsh 3 Histopathology in Adult and Pediatric Celiac Disease." Journal of Clinical Gastroenterology, vol. 42, no. 3, 2008, pp. 256-60.
Donaldson MR, Book LS, Leiferman KM, et al. Strongly positive tissue transglutaminase antibodies are associated with Marsh 3 histopathology in adult and pediatric celiac disease. J Clin Gastroenterol. 2008;42(3):256-60.
Donaldson, M. R., Book, L. S., Leiferman, K. M., Zone, J. J., & Neuhausen, S. L. (2008). Strongly positive tissue transglutaminase antibodies are associated with Marsh 3 histopathology in adult and pediatric celiac disease. Journal of Clinical Gastroenterology, 42(3), pp. 256-60. doi:10.1097/MCG.0b013e31802e70b1.
Donaldson MR, et al. Strongly Positive Tissue Transglutaminase Antibodies Are Associated With Marsh 3 Histopathology in Adult and Pediatric Celiac Disease. J Clin Gastroenterol. 2008;42(3):256-60. PubMed PMID: 18223500.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Strongly positive tissue transglutaminase antibodies are associated with Marsh 3 histopathology in adult and pediatric celiac disease. AU - Donaldson,Matthew R, AU - Book,Linda S, AU - Leiferman,Kristin M, AU - Zone,John J, AU - Neuhausen,Susan L, PY - 2008/1/29/pubmed PY - 2008/5/28/medline PY - 2008/1/29/entrez SP - 256 EP - 60 JF - Journal of clinical gastroenterology JO - J. Clin. Gastroenterol. VL - 42 IS - 3 N2 - GOALS: Our objective was to determine whether high serologic IgA tissue transglutaminase antibodies (TTGA) are exclusively associated with celiac disease (CD). BACKGROUND: IgA TTGA are found in the serum of most individuals with CD. This serologic marker is used to screen individuals with suspected CD for duodenal biopsy, the gold standard of CD diagnosis. Data suggest strongly positive IgA TTGA >or= 100 units are highly specific for CD histopathology in pediatric patients and may be sufficient for diagnosis. STUDY: Records of adult and pediatric subjects in the celiac study at the University of Utah and University of California Irvine were reviewed for strongly positive TTGA. Pathology reports from duodenal biopsies of subjects with IgA TTGA >or= 100 units were graded as 0 to 3 by modified Marsh criteria. RESULTS: From a pool of 1882 subjects with IgA TTGA assayed, 208 had IgA TTGA >or= 100 units. Seventy-six of these, including 28 children and 48 adults, also had duodenal biopsies. Villous atrophy (Marsh 3 histopathology) was found on biopsy in 73 (96%) of these subjects. The remaining 3 subjects had intermediate Marsh histology. One (Marsh 1) had a complete serologic response to a gluten-free diet and 2 had Marsh 2 lesions and positive endomysium, making early CD most likely. CONCLUSIONS: IgA TTGA >or= 100 units occur almost exclusively in the setting of Marsh 3 duodenal histopathology in adults and children. Rare cases without villous atrophy were marked by intermediate Marsh changes suggestive of early CD. IgA TTGA >or= 100 arbitrary units indicate duodenal changes consistent with CD. SN - 0192-0790 UR - https://www.unboundmedicine.com/medline/citation/18223500/Strongly_positive_tissue_transglutaminase_antibodies_are_associated_with_Marsh_3_histopathology_in_adult_and_pediatric_celiac_disease_ L2 - http://dx.doi.org/10.1097/MCG.0b013e31802e70b1 DB - PRIME DP - Unbound Medicine ER -