Transglutaminase antibodies in children with a genetic risk for celiac disease.
OBJECTIVE
The transglutaminase (TG) antibody test is accurate in identifying celiac disease in symptomatic children. We sought to determine the positive predictive value of this test in asymptomatic children at genetic risk for celiac disease.


METHODS
Asymptomatic children with a genetic risk for celiac disease were studied to investigate the relationships between TG antibody titer, small bowel histology, growth, and clinical features. Small bowel biopsy histology was graded by using the system of Marsh.


RESULTS
Of 30 children with a positive TG antibody test result, 21 (70%) had definite (Marsh score 2 or 3) and 4 (13%) had possible (Marsh score 1) biopsy evidence of celiac disease. TG antibody titer correlated with Marsh score (r = 0.569, P <.01). There was an inverse correlation between Marsh score and height z score (r = -0.361, P =. 05).


CONCLUSIONS
In this group of asymptomatic children screened because of a genetic risk, TG antibodies have a positive predictive value of 70% to 83% for biopsy evidence of celiac disease and may identify children before clinical features of celiac disease develop.
Hoffenberg
E J
EJ
Section of Pediatric Gastroenterology, Hepatology, and Nutrition, Center for Pediatric Inflammatory Bowel Diseases, Department of Pediatrics, Barbara Davis Center for Childhood Diabetes, Denver, Colorado, USA.
Bao
F
F
Eisenbarth
G S
GS
Uhlhorn
C
C
Haas
J E
JE
Sokol
R J
RJ
Rewers
M
M
D000293:Adolescent; D001323:Autoantibodies / Q000032:analysis*; D002446:Celiac Disease / Q000175:diagnosis / Q000201:enzymology* / Q000235:genetics*; D002648:Child; D002675:Child, Preschool; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D007421:Intestine, Small / Q000201:enzymology / Q000276:immunology / Q000473:pathology; D008297:Male; D011237:Predictive Value of Tests; D011863:Radioimmunoassay; D018709:Statistics, Nonparametric; D011503:Transglutaminases / Q000276:immunology*
D001323:Autoantibodies; D011503:Transglutaminases