Hoffenberg EJ, Bao F, Eisenbarth GS, et al. Transglutaminase antibodies in children with a genetic risk for celiac disease
ABSTRACT The transglutaminase (TG) antibody test is accurate in identifying celiac disease in symptomatic children. We sought to determine the positive predictive value of this test in asymptomatic children at genetic risk for celiac disease.
Asymptomatic children with a genetic risk for celiac disease were studied to investigate the relationships between TG antibody titer, small bowel histology, growth, and clinical features. Small bowel biopsy histology was graded by using the system of Marsh.
Of 30 children with a positive TG antibody test result, 21 (70%) had definite (Marsh score 2 or 3) and 4 (13%) had possible (Marsh score 1) biopsy evidence of celiac disease. TG antibody titer correlated with Marsh score (r = 0.569, P <.01). There was an inverse correlation between Marsh score and height z score (r = -0.361, P =. 05).
In this group of asymptomatic children screened because of a genetic risk, TG antibodies have a positive predictive value of 70% to 83% for biopsy evidence of celiac disease and may identify children before clinical features of celiac disease develop.
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ABSTRACT: Celiac disease (CD) is a disease of the small intestine character- ized by villous atrophy that impairs with nutrient absorption and improves upon withdrawal from wheat gliadin barley, rye and oat prolamines of the diet. Susceptibility to celiac disease is determined significantly by genetic factors. Extraintestinal manifestations have been increasingly recognized and the strict association with dis- eases, characterized as autoimmune, is well established. Although a diagnostic and subsequent follow-up jejunal biopsy are neces- sary in children in order to confirm diagnosis, anti-gliadin IgA and IgG, anti-reticulin and anti-endomysium antibodies, are now reliable in identifying children with celiac disease and are valuable in moni- toring the adequacy of gluten withdrawal. A lifelong strict gluten free diet is essential to reduce the chance of developing late gas- trointestinal malignancy. Celiac disease is important for both clini- cians and scientists because it represents a valuable model for comprehension of diseases in which environmental, genetic and
- Diabetes Technology & Therapeutics 02/2000; 2(4):609-16. · 2.29 Impact Factor
- Diabetes Technology & Therapeutics 12/2000; 2(4):609-616. DOI:10.1089/15209150050502032 · 2.29 Impact Factor