title: Evaluation of the Correlation Between tTG-IgA Titer and Duodenal Biopsy Findings in Children With Suspected Celiac Disease.
abstract: BACKGROUND
  Celiac disease is an immune-mediated inflammation of the small intestine caused by sensitivity to dietary gluten in genetically sensitive individuals.
  
  
  OBJECTIVE
  In this study, we aimed to evaluate the predictive value of tissue transglutaminase (tTG) antibodies for the diagnosis of celiac disease in a pediatric population in order to determine if duodenal biopsy can be avoided.
  
  
  METHODS
  The subjects were selected among individuals with probable celiac disease, referring to a gastrointestinal clinic. After physical examinations and performing tissue transglutaminase-immunoglobulin A (tTG-IgA) tests, upper endoscopy was performed if serological titer was higher than 18 IU/mL. Therapy started according to pathologic results.
  
  
  RESULTS
  The sample size was calculated to be 121 subjects (69 female and 52 male subjects); the average age of subjects was 8.4 years. A significant association was found between serological titer and pathologic results; in other words, subjects with high serological titer had more positive pathologic results for celiac disease, compared to others (P < 0.001). Maximum sensitivity (65%) and specificity (65.4%) were achieved at a serological titer of 81.95 IU/ml; the calculated accuracy was lower in comparison with other studies. As the results indicated, lower antibody titer was observed in patients with failure to gain weight and higher antibody titer was reported in diabetic patients.
  
  
  CONCLUSIONS
  As the results indicated, a single serological test (tTg-IgA test) was not sufficient for avoiding intestinal biopsy.
authors: Department of Pediatrics, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors: Mitra-Azra
authors: MA
authors: Aldaghi
authors: Department of Pediatrics, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors: Seyed-Mohsen
authors: SM
authors: Dehghani
authors: Department of Pediatrics, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors: Mahmood
authors: M
authors: Haghighat
keywords: Celiac Disease; Diagnostic Accuracy; Small Bowel Biopsy; tTG-IgA