title: Prevalence and clinical significance of IgA anti-tissue transglutaminase antibodies in patients with chronic liver disease.
abstract: OBJECTIVE
  Celiac disease is a multi-systemic disease, which can affect any organ system including liver. However, the prevalence of celiac disease and the sensitivity and specificity of anti-tissue transglutaminase (anti-tTG) in diagnosing celiac disease in patients with cirrhosis of liver is not well established.
  
  
  METHODS
  We screened a cohort of patients with chronic liver disease for an associated diagnosis of celiac disease. Anti-tTG was carried out in all patients, and those with a high value were subjected to duodenal biopsy for histological confirmation. In patients where biopsy was contraindicated or refused, anti-endomysial antibody (anti-EMA) was tested.
  
  
  RESULTS
  Of a total of 595 patients with chronic liver disease, high levels of anti-tTG were noted in 150 (25.2%) patients, and celiac disease was diagnosed in 14 patients (2.4%). Celiac autoimmunity (high levels of both anti-tTG and anti-EMA) was noted in seven patients (1.2%).
  
  
  CONCLUSIONS
  Although a large number of cirrhotic patients have high levels of anti-tTG, duodenal histology and/or anti-EMA is normal in majority of these patients. This suggests high false positivity of anti-tTG in patients with cirrhosis and highlights the need of duodenal biopsy for histological confirmation of the diagnosis of celiac disease.
authors.affiliation: Department of Gastroenterology, Dayanand Medical College, Ludhiana, Punjab, India.
authors.forename: Ajit
authors.initials: A
authors.lastname: Sood
authors.affiliation: Department of Internal Medicine, Dayanand Medical College, Ludhiana, Punjab, India.
authors.forename: Manbir Singh
authors.initials: MS
authors.lastname: Khurana
authors.affiliation: Department of Gastroenterology, Dayanand Medical College, Ludhiana, Punjab, India.
authors.forename: Ramit
authors.initials: R
authors.lastname: Mahajan
authors.affiliation: Department of Internal Medicine, Dayanand Medical College, Ludhiana, Punjab, India.
authors.forename: Vandana
authors.initials: V
authors.lastname: Midha
authors.affiliation: Department of Internal Medicine, Dayanand Medical College, Ludhiana, Punjab, India.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Puri
authors.affiliation: Department of Internal Medicine, Dayanand Medical College, Ludhiana, Punjab, India.
authors.forename: Amandeep
authors.initials: A
authors.lastname: Kaur
authors.affiliation: Department of Internal Medicine, Dayanand Medical College, Ludhiana, Punjab, India.
authors.forename: Nishit
authors.initials: N
authors.lastname: Gupta
authors.affiliation: College of Nursing, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
authors.forename: Suresh
authors.initials: S
authors.lastname: Sharma
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002446:Celiac Disease / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D002648:Child; D015331:Cohort Studies; D005189:False Positive Reactions; D005260:Female; D019204:GTP-Binding Proteins / Q000276:immunology*; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood*; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D012680:Sensitivity and Specificity; D011503:Transglutaminases / Q000276:immunology*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D007070:Immunoglobulin A; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases; D019204:GTP-Binding Proteins
keywords: anti-tissue transglutaminase; celiac disease; chronic liver disease