Diagnostic usefulness of Anti-Tissue Transglutaminase in Celiac Disease: Correlation with Intestinal Mucosal Biopsy

Objective: To describe the clinical value of Anti-tTG (IgA, IgG) in the diagnostic work-up of celiac disease patients. Methodology: Children with clinical suspicion of celiac disease, presenting in Gastroenterology and Hepatology out patient department, Children’s Hospital The Institute of Child Health, Multan were recruited. It was a descriptive case series, study was conducted from Jan 2007 to Jan 2009, blood samples for Anti-tTGs (IgG, IgA) duodenal biopsies for histological analysis were taken. Data was analyzed for descriptive analysis. Results: Sixty patients with symptoms suggestive of celiac disease were submitted for Anti-tTGs (IgG, IgA) duodenal biopsy, 46 patients had histological changes according to the Marsh criteria and 49 had raised Anti-tTGs. A total of 54 patients who had one or both the tests positive, were considered for final analysis. 41 patients showed histological changes of celiac disease on duodenal biopsy and raised Anti-tTGs, 5 patients with histological changes of celiac disease had Anti-tTGs levels within normal limits. Five patients with raised Anti-tTGs levels had nonspecific inflammatory changes (not consistent with celiac disease) and 3 patients with raised Anti-tTGs levels had normal histology of intestinal mucosa. Conclusion: Anti-tTGs (IgA, IgG) is very valuable screening marker in the diagnostic work-up of celiac disease, specially in selecting the patients for duodenal biopsies.