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Diagnostic accuracy of IgA anti-tissue transglutaminase in patients suspected of having coeliac disease in Iran.

Abstract

BACKGROUND AND AIM

As there are little data about the sensitivity of the IgA anti-tissue transglutaminase (IgA anti-tTG) antibody test in the clinical practice setting, we evaluated the sensitivity of this serologic test in a group of patients who were suspected of having coeliac disease and had serologic testing performed at commercial laboratories.

PATIENTS AND METHODS

The study was performed at Poursina Hakim Research Institute in Isfahan-Iran. A total number of 350 consecutive patients were enrolled in our study. They were divided into 3 groups: classical mode of presentation, atypical mode of presentation and patients with non specific prolonged gastrointestinal symptoms. Upper gastrointestinal endoscopy, histopathologic examination of biopsies from the second part of duodenum and serologic evaluation were performed for every patient. Biopsy specimens were evaluated according to Marsh (1992, revised in 1997).

RESULTS

The overall sensitivity and specificity of IgA anti-tTG antibody were 38% and 98%. The positive and negative predictive values for the anti-tTG antibodies were 57% and 96%, respectively. The sensitivity was 80% in patients with Marsh IIIC.

CONCLUSION

In contrast to other reports suggesting a diagnostic accuracy of more than 90% for anti-tTG antibody in coeliac disease patients, our data showed that we are still far from an ideal screening serologic tool which can rely on the antibody test as the sole way of identifying patients with coeliac disease. This could result in many missed diagnoses, in particular in patients with lesser degrees of Marsh classification.

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  • Authors+Show Affiliations

    ,

    Poursina Hakim Research Institute & Isfahan University of Medical Science, Bozorgmehr Avenue, Isfahan, Iran. mh_emami@med.mui.ac.ir

    , , ,

    Source

    MeSH

    Adolescent
    Adult
    Antibodies, Anti-Idiotypic
    Biopsy
    Celiac Disease
    Child
    Child, Preschool
    Duodenum
    Endoscopy, Gastrointestinal
    Enzyme-Linked Immunosorbent Assay
    Female
    GTP-Binding Proteins
    Humans
    Immunoglobulin A
    Iran
    Male
    Middle Aged
    Prevalence
    Reproducibility of Results
    Retrospective Studies
    Transglutaminases

    Pub Type(s)

    Comparative Study
    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    18568134

    Citation

    Emami, Mohammad Hasan, et al. "Diagnostic Accuracy of IgA Anti-tissue Transglutaminase in Patients Suspected of Having Coeliac Disease in Iran." Journal of Gastrointestinal and Liver Diseases : JGLD, vol. 17, no. 2, 2008, pp. 141-6.
    Emami MH, Karimi S, Kouhestani S, et al. Diagnostic accuracy of IgA anti-tissue transglutaminase in patients suspected of having coeliac disease in Iran. J Gastrointestin Liver Dis. 2008;17(2):141-6.
    Emami, M. H., Karimi, S., Kouhestani, S., Hashemi, M., & Taheri, H. (2008). Diagnostic accuracy of IgA anti-tissue transglutaminase in patients suspected of having coeliac disease in Iran. Journal of Gastrointestinal and Liver Diseases : JGLD, 17(2), pp. 141-6.
    Emami MH, et al. Diagnostic Accuracy of IgA Anti-tissue Transglutaminase in Patients Suspected of Having Coeliac Disease in Iran. J Gastrointestin Liver Dis. 2008;17(2):141-6. PubMed PMID: 18568134.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Diagnostic accuracy of IgA anti-tissue transglutaminase in patients suspected of having coeliac disease in Iran. AU - Emami,Mohammad Hasan, AU - Karimi,Somayeh, AU - Kouhestani,Soheila, AU - Hashemi,Marzieh, AU - Taheri,Hajar, PY - 2008/6/24/pubmed PY - 2008/9/5/medline PY - 2008/6/24/entrez SP - 141 EP - 6 JF - Journal of gastrointestinal and liver diseases : JGLD JO - J Gastrointestin Liver Dis VL - 17 IS - 2 N2 - BACKGROUND AND AIM: As there are little data about the sensitivity of the IgA anti-tissue transglutaminase (IgA anti-tTG) antibody test in the clinical practice setting, we evaluated the sensitivity of this serologic test in a group of patients who were suspected of having coeliac disease and had serologic testing performed at commercial laboratories. PATIENTS AND METHODS: The study was performed at Poursina Hakim Research Institute in Isfahan-Iran. A total number of 350 consecutive patients were enrolled in our study. They were divided into 3 groups: classical mode of presentation, atypical mode of presentation and patients with non specific prolonged gastrointestinal symptoms. Upper gastrointestinal endoscopy, histopathologic examination of biopsies from the second part of duodenum and serologic evaluation were performed for every patient. Biopsy specimens were evaluated according to Marsh (1992, revised in 1997). RESULTS: The overall sensitivity and specificity of IgA anti-tTG antibody were 38% and 98%. The positive and negative predictive values for the anti-tTG antibodies were 57% and 96%, respectively. The sensitivity was 80% in patients with Marsh IIIC. CONCLUSION: In contrast to other reports suggesting a diagnostic accuracy of more than 90% for anti-tTG antibody in coeliac disease patients, our data showed that we are still far from an ideal screening serologic tool which can rely on the antibody test as the sole way of identifying patients with coeliac disease. This could result in many missed diagnoses, in particular in patients with lesser degrees of Marsh classification. SN - 1841-8724 UR - https://www.unboundmedicine.com/medline/citation/18568134/Diagnostic_accuracy_of_IgA_anti_tissue_transglutaminase_in_patients_suspected_of_having_coeliac_disease_in_Iran_ L2 - http://www.jgld.ro/2008/2/2.html DB - PRIME DP - Unbound Medicine ER -