Accuracy of Anti-Tissue Transglutaminase IgA Antibody in the Diagnosis of Paediatric Celiac Disease.
OBJECTIVE
To determine the accuracy of anti-tissue transglutaminase IgA (TTG) antibody titer in the diagnosis of celiac disease, taking small intestine histopathology as the gold standard.


METHODS
Cross-sectional analytical study.


METHODS
Department of Paediatrics, Benazir Bhutto Hospital, Rawalpindi, from February to July 2013.


METHODS
Sixty patients aged 2 - 13 years, admitted in the Paediatric Department of Benazir Bhutto Hospital, Rawalpindi, having at least 3 features from chronic diarrhea, malnutrition, short stature, anemia, abdominal distension and clubbing, were included. Age, gender, weight and height were recorded. Abdominal distension and clubbing were clinically noted. For hemoglobin, blood complete picture was done. For determination of nutritional status and short stature, standard centile charts were used. TTG titer upper GI endoscopy, duodenal biopsy, and histopathology were done in all cases.


RESULTS
There were 60 patients; 32 males, 28 females with mean age of 5.85 &amp;plusmn;3.36 years. Frequency of CD was 63.33% in study population. Sensitivity of TTG was 86.84%, with 81.82% specificity, 89.19% positive predictive value, and 78.26% negative predictive value for diagnosing CD. TTG titre more than 50 iu/ml had a 100% positive predictive value.


CONCLUSIONS
TTG is an excellent screening test for the diagnosis of paediatric CD. TTG value &amp;gt; 50 IU/ml has 100% positive predictive value.
Department of Paediatric Gastroenterology, The Children&amp;#039;s Hospital and The Institute of Child Health, Lahore.
Muhammad Almas
MA
Hashmi
Department of Medicine, Benazir Bhutto Hospital, Rawalpindi.
Tanveer
T
Hussain
Department of Paediatric, Benazir Bhutto Hospital, Rawalpindi.
Najaf
N
Masood
Department of Pathology, Benazir Bhutto Hospital, Rawalpindi.
Muhammad
M
Younas
Department of Paediatric, Benazir Bhutto Hospital, Rawalpindi.
Rai Muhammad
RM
Asghar
Department of Medicine, Benazir Bhutto Hospital, Rawalpindi.
Muhammad Shoaib
MS
Shafi
D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D001323:Autoantibodies / Q000032:analysis / Q000097:blood*; D001706:Biopsy; D002446:Celiac Disease / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D004386:Duodenum / Q000473:pathology*; D004724:Endoscopy; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D019204:GTP-Binding Proteins / Q000097:blood / Q000276:immunology*; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood / Q000276:immunology*; D007421:Intestine, Small / Q000473:pathology; D008297:Male; D008403:Mass Screening / Q000379:methods; D011237:Predictive Value of Tests; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D012680:Sensitivity and Specificity; D011503:Transglutaminases / Q000097:blood / Q000276:immunology*
D001323:Autoantibodies; D007070:Immunoglobulin A; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases; D019204:GTP-Binding Proteins