IgA anti-tissue transglutaminase antibodies, first line in the diagnosis of celiac disease.
BACKGROUND
According to the 2008 celiac disease working group run by Dr. A. Fassano under the auspices of the Federation of International Societies of Pediatric Gastroenterology, Hepatology and Nutrition, celiac disease is a chronic immune-mediated enteropathy characterized by gluten sensitivity, which can affect any organ or system, having a wide range of clinical manifestations of variable severity. The serological diagnosis of celiac disease is based on high sensitivity and specificity tests. The measurement of IgA anti-tissue transglutaminase antibodies by ELISA is universally accepted in the screening of celiac disease.


METHODS
Using the gold standard represented by IgA anti-endomysium antibodies in a group of 890 children investigated during 2008-2009, we aimed to evaluate IgA anti-tissue transglutaminase antibodies (tTG IgA), as well as to establish their prevalence in associated diseases.


RESULTS
Following the measurement of tTG IgA in the entire group, we obtained: sensitivity 773%, positive predictive value 55.2%, specificity 93.1%, negative predictive value 973%, p = 0.000, and in tTG IgA associations we obtained the value 0.51 for the ROC curve area. We found associations of tTG IgA with type 1 diabetes mellitus (235% prevalence), protein-calorie malnutrition (0.89% prevalence), and intestinal malabsorption (0.56% prevalence).


CONCLUSIONS
Our results have a high specificity and sensitivity in the screening of celiac disease, while requiring a second method of confirmation.
Department of Lmmunopathology, "Iuliu Haţieganu" University of Medicine andPharmacy Cluj-Napoca, Romania. Gabriel.Samasca@umfcluj.ro
Gabriel
G
Samaşca
Mihaela
M
Iancu
Dorin
D
Farcău
Angela
A
Butnariu
Tudor
T
Pop
Alexandru
A
Pîrvan
Mariana
M
Andreica
Nicolae
N
Miu
Victor
V
Cristea
Doru
D
Dejica
D019540:Area Under Curve; D001323:Autoantibodies / Q000032:analysis; D002446:Celiac Disease / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D002648:Child; D015362:Child Nutrition Disorders / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D015897:Comorbidity; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis; D008286:Malabsorption Syndromes / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000379:methods; D011237:Predictive Value of Tests; D015995:Prevalence; D011502:Protein-Energy Malnutrition / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D012372:ROC Curve; D012383:Romania; D011503:Transglutaminases / Q000276:immunology*
D001323:Autoantibodies; D007070:Immunoglobulin A; D011503:Transglutaminases