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Clinical and histopathological correlation of duodenal biopsy with IgA anti-tissue transglutaminase titers in children with celiac disease.
Indian J Gastroenterol 2014; 33(4):350-4IJ

Abstract

BACKGROUND

Data correlating anti-tissue transglutaminase (tTG) antibody titers with severity of duodenal involvement is limited.

OBJECTIVE

The aim of this study was to correlate IgA anti-tTG antibody titers with symptoms, anthropometric parameters, and duodenal histopathology.

METHODS

Consecutively diagnosed patients of celiac disease as per modified ESPGHAN criteria presenting over a year were enrolled. Demographic data, symptoms, weight-for-age z score (WAZ), height-for-age z score (HAZ), IgA anti-tTG titer, and duodenal histopathology graded as per modified Marsh criteria were recorded. Spearman rank correlation test was used for association between TTG age, WAZ, and HAZ. Receiver operating curve (ROC), sensitivity, specificity, negative predictive value, and positive predictive value were used to obtain anti-tTG cutoff value predictive of Marsh grade 3.

RESULTS

One hundred and forty-two patients with celiac disease were evaluated. tTG showed significant correlation with WAZ (r = 0.822, p = <0.001) and HAZ (r = 0.722, p = <0.001) but not with age (r = 0.202, p = 0.066). The median anti-tTG titers rose progressively with higher Marsh grade on histopathology (p = 0.001). The median anti-tTG titer was also significantly higher in patients with classic celiac disease as compared to non-diarrheal celiac disease (144 u/mL vs. 27, p = 0.02). Anti-tTG titer of 62.5 u/mL was strongly predictive of duodenal histology of Marsh grade 3a and higher with sensitivity, specificity, positive predictive value, and negative predictive value of 95.4 %, 98 %, 93.8 %, and 88.3 % respectively.

CONCLUSIONS

There is a significant correlation between IgA anti-tTG titers and anthropometric parameters and severity of duodenal histopathology. With further validation, strongly positive titers may be sufficient to predict severity of this disease.

Authors+Show Affiliations

Department of Pediatrics, Lok Nayak Hospital and Maulana Azad Medical College, Bahadur Shah Zafar Marg, New Delhi, 110 002, India.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24859392

Citation

Bhattacharya, Malobika, et al. "Clinical and Histopathological Correlation of Duodenal Biopsy With IgA Anti-tissue Transglutaminase Titers in Children With Celiac Disease." Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology, vol. 33, no. 4, 2014, pp. 350-4.
Bhattacharya M, Lomash A, Sakhuja P, et al. Clinical and histopathological correlation of duodenal biopsy with IgA anti-tissue transglutaminase titers in children with celiac disease. Indian J Gastroenterol. 2014;33(4):350-4.
Bhattacharya, M., Lomash, A., Sakhuja, P., Dubey, A. P., & Kapoor, S. (2014). Clinical and histopathological correlation of duodenal biopsy with IgA anti-tissue transglutaminase titers in children with celiac disease. Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology, 33(4), pp. 350-4. doi:10.1007/s12664-014-0464-0.
Bhattacharya M, et al. Clinical and Histopathological Correlation of Duodenal Biopsy With IgA Anti-tissue Transglutaminase Titers in Children With Celiac Disease. Indian J Gastroenterol. 2014;33(4):350-4. PubMed PMID: 24859392.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical and histopathological correlation of duodenal biopsy with IgA anti-tissue transglutaminase titers in children with celiac disease. AU - Bhattacharya,Malobika, AU - Lomash,Avinash, AU - Sakhuja,Puja, AU - Dubey,Anand Prakash, AU - Kapoor,Seema, Y1 - 2014/05/24/ PY - 2013/10/08/received PY - 2014/04/06/accepted PY - 2014/5/27/entrez PY - 2014/5/27/pubmed PY - 2015/10/20/medline SP - 350 EP - 4 JF - Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology JO - Indian J Gastroenterol VL - 33 IS - 4 N2 - BACKGROUND: Data correlating anti-tissue transglutaminase (tTG) antibody titers with severity of duodenal involvement is limited. OBJECTIVE: The aim of this study was to correlate IgA anti-tTG antibody titers with symptoms, anthropometric parameters, and duodenal histopathology. METHODS: Consecutively diagnosed patients of celiac disease as per modified ESPGHAN criteria presenting over a year were enrolled. Demographic data, symptoms, weight-for-age z score (WAZ), height-for-age z score (HAZ), IgA anti-tTG titer, and duodenal histopathology graded as per modified Marsh criteria were recorded. Spearman rank correlation test was used for association between TTG age, WAZ, and HAZ. Receiver operating curve (ROC), sensitivity, specificity, negative predictive value, and positive predictive value were used to obtain anti-tTG cutoff value predictive of Marsh grade 3. RESULTS: One hundred and forty-two patients with celiac disease were evaluated. tTG showed significant correlation with WAZ (r = 0.822, p = <0.001) and HAZ (r = 0.722, p = <0.001) but not with age (r = 0.202, p = 0.066). The median anti-tTG titers rose progressively with higher Marsh grade on histopathology (p = 0.001). The median anti-tTG titer was also significantly higher in patients with classic celiac disease as compared to non-diarrheal celiac disease (144 u/mL vs. 27, p = 0.02). Anti-tTG titer of 62.5 u/mL was strongly predictive of duodenal histology of Marsh grade 3a and higher with sensitivity, specificity, positive predictive value, and negative predictive value of 95.4 %, 98 %, 93.8 %, and 88.3 % respectively. CONCLUSIONS: There is a significant correlation between IgA anti-tTG titers and anthropometric parameters and severity of duodenal histopathology. With further validation, strongly positive titers may be sufficient to predict severity of this disease. SN - 0975-0711 UR - https://www.unboundmedicine.com/medline/citation/24859392/Clinical_and_histopathological_correlation_of_duodenal_biopsy_with_IgA_anti_tissue_transglutaminase_titers_in_children_with_celiac_disease_ L2 - https://dx.doi.org/10.1007/s12664-014-0464-0 DB - PRIME DP - Unbound Medicine ER -