| Correlation Between IgA Tissue Transglutaminase Antibody Ratio And Histological Finding In Celiac Disease: A Multicentre Study. | |
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MedLine Citation:
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PMID: 22197946 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVES:: Positivity of both IgA anti-Tissue Transglutaminase (TTG) and anti-endomysium (EMA) antibodies has a positive predictive value (PPV) of nearly 100% for celiac disease (CD).Objective of this study is evaluate if patients of any age, with high pre-test probability of CD and high titre of anti-TTG and EMA positivity, have a high probability of intestinal damage and may not require the biopsy for final diagnosis. PATIENTS AND METHODS:: A retrospective analysis of 412 consecutively referred patients, age range 10m-72y, who underwent small-bowel biopsy for suspect of CD and positivity to both anti-TTG and EMA, was performed in four Italian centres.Biopsies were evaluated independently by two pathologists, using Marsh modified classification; in case of dissimilar results, a third pathologist examined the biopsy; the final histological finding diagnosis was expressed as the prevalent or highest score assigned by the pathologists board. RESULTS:: 396 patients (96.1%) had histological findings consistent with CD (grade 2 and 3a, 3b or 3c of modified Marsh classification).An anti-TTG ratio of 7 or higher was able to identify with the three assays used (Celikey, Phadia; Orgentec Diagnostika; EuTTG, Eurospital) all the patients with significant mucosal damage (Marsh ≥2) independently to age and sex; specificity and PPV resulted 100%. An anti-TTG ratio >20 was more specific (99.8%) for identify patients with villous atrophy (Marsh 3 a, b or c). CONCLUSION:: Patients with positivity of anti-TTG ≥7 fold cut off, confirmed by positivity to EMA, have a high degree probability of duodenal damage. In selected conditions, a duodenal biopsy may be avoided and a confirmed highly positive anti-TTG result could be the basis to prescribe a gluten free diet. |
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Authors:
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Mariagrazia Alessio; Elio Tonutti; Ignazio Brusca; Antonella Radice; Lisa Licini; Aurelio Sonzogni; Ada Florena; Eugenio Schiaffino; Wally Marus; Sandro Sulfaro; Danilo Villalta |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-12-22 |
Journal Detail:
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Title: Journal of pediatric gastroenterology and nutrition Volume: - ISSN: 1536-4801 ISO Abbreviation: - Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2011-12-26 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8211545 Medline TA: J Pediatr Gastroenterol Nutr Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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*Biochemistry Laboratory, Department of Laboratory Medicine, Riuniti Hospital, Bergamo †Immunopathology and Allergology Unit, S. Maria della Misericordia Hospital, Udine ‡Clinical Pathology, Buccheri La Ferla Hospital, Palermo §Microbiology and Virology Laboratory, San Carlo Hospital, Milano ||Pathological Anatomy, Department of Laboratory Medicine, Riuniti Hospital, Bergamo ¶Department of Human Pathology, University of Palermo, Palermo #Pathological Anatomy and Histology, San Carlo Hospital, Milano **Pathological Anatomy, Santa Maria degli Angely Hospital, Pordenone ††Allergy and Clinical Immunology, Departement of Laboratory Medicine, S. Maria degli Angeli Hospital, Pordenone 1For the Study Group on Autoimmune Diseases of the Italian Society of Laboratory Medicine (SIMeL). |
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