title: Correlation Between Cut-off Level of Tissue Transglutaminase Antibody and Marsh Classification.
abstract: BACKGROUND Duodenal biopsy is required for diagnosis of celiac disease in adults, although some studies have suggested adequate accuracy of serology alone.
  
  
  OBJECTIVE
  We aimed to assess the correlation between anti-tissue transglutaminase (tTG) titer and pathological findings and to define the specific level of tTG for predicting celiac disease in adults without the need for biopsy sampling. METHODS This descriptive study was done on 299 participants. The tTG titer and pathological findings of duodenal biopsy samples were used for this study. Analysis of Receiver operating characteristic (ROC) curve was used to find a cut-off point of anti-tTG antibody for mucosal atrophy. RESULTS Mean tTG titers was significantly higher in patients graded as Marsh III≥ 3 (p=0.023). ROC curve analysis showed 89.1% sensitivity for cut-off point≥76.5 IU/mL of anti-tTG. For Marsh≥ II, specificity was 28% and positive predictive value was 91%.CON CLUSION There is a linear correlation between increasing tTG level and Marsh I to III. Specificity of tTG titer more than 200 was 100% for Marsh >2.
authors.affiliation: Gastroenterology and Hepatology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Azita
authors.initials: A
authors.lastname: Ganji
authors.affiliation: Gastroenterology and Hepatology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Abbas
authors.initials: A
authors.lastname: Esmaeilzadeh
authors.affiliation: Gastroenterology and Hepatology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Bahari
authors.affiliation: Mashhad Pathobiology Laboratory, Mashhad, Iran.
authors.forename: Kamran
authors.initials: K
authors.lastname: Ghafarzadegan
authors.affiliation: Gastroenterology and Hepatology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Afzal Aghayee
authors.affiliation: Gastroenterology and Hepatology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Homan
authors.initials: H
authors.lastname: Mosanen Mozafari
authors.affiliation: Gastroenterology and Hepatology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Abdolrasol
authors.initials: A
authors.lastname: Hayatbakhsh
authors.affiliation: PHD candidate in Biostatistics, Department of Epidemiology and Biostatistics, School of Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Vahid
authors.initials: V
authors.lastname: Ghavami Ghanbarabadi
authors.affiliation: Gastroenterology and Hepatology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Behdad
authors.initials: B
authors.lastname: Ravarian
authors.affiliation: Gastroenterology and Hepatology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Leili
authors.initials: L
authors.lastname: Rahimi
keywords: Celiac Disease; Diagnosis; Pathology; Tissue transglutaminase antibody