title: Antibody testing in Indian children with celiac disease.
abstract: BACKGROUND
  We prospectively evaluated the usefulness of IgA tissue transglutaminase antibodies (IgA tTG) in the initial diagnosis of celiac disease (CD) and compared its diagnostic potential with that of IgA anti-endomysial antibodies (IgA EMA) and anti-IgA and IgG gliadin antibodies (AGA and AGG, respectively).
  
  
  METHODS
  Sera of 23 untreated children fulfilling the revised ESPGHAN criteria for diagnosis of CD (Group I; mean age 10.8 y); 19 disease controls (Group II; mean age 8.5 y) presenting with chronic diarrhea, short stature or both; and 22 healthy children (Group III; mean age 8.8 y) were studied. These were tested in a blinded manner for AGA, AGG, IgA tTG (guinea pig as antigen) and IgA EMA.
  
  
  RESULTS
  In Group I, IgA EMA was positive in 19, IgA tTG in 17, AGA in 14 and AGG in 17 patients. In Group II, these tests were positive in 1, 0, 2 and 14 patients, respectively and in Group III, in 0, 0, 0 and 1 child, respectively. Analyzing data from Group I and II, IgA EMA, IgA tTG, AGA and AGG had sensitivity rates of 83%, 74%, 61% and 74%, respectively; the specificity rates were 95%, 100%, 89% and 26%; positive predictive values were 95%, 100%, 88% and 55% and negative predictive values were 82%, 74%, 65% and 45%, respectively.
  
  
  CONCLUSIONS
  IgA tTG is useful for the diagnosis of CD, with sensitivity and specificity rates comparable to those of EMA and this test is well suited for use in tropical countries like India.
authors.affiliation: Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow - 226 014, India. skyachha@sgpgi.ac.in
authors.forename: Surender Kumar
authors.initials: SK
authors.lastname: Yachha
authors.forename: Rakesh
authors.initials: R
authors.lastname: Aggarwal
authors.forename: S
authors.initials: S
authors.lastname: Srinivas
authors.forename: Anshu
authors.initials: A
authors.lastname: Srivastava
authors.forename: Sanjay K
authors.initials: SK
authors.lastname: Somani
authors.forename: Srivenu
authors.initials: S
authors.lastname: Itha
mesh_terms: D000293:Adolescent; D000888:Antibodies, Anti-Idiotypic / Q000097:blood / Q000276:immunology; D001323:Autoantibodies / Q000097:blood*; D016022:Case-Control Studies; D002446:Celiac Disease / Q000276:immunology* / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D004386:Duodenum / Q000473:pathology; D005260:Female; D005903:Gliadin / Q000097:blood / Q000276:immunology; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood / Q000276:immunology; D007074:Immunoglobulin G / Q000097:blood / Q000276:immunology; D007194:India; D008297:Male; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D011503:Transglutaminases / Q000097:blood / Q000276:immunology
chemical_list: D000888:Antibodies, Anti-Idiotypic; D001323:Autoantibodies; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D005903:Gliadin; D011503:Transglutaminases