Diagnostic accuracy of serum anti-tissue transglutaminase IgA,in the diagnosis of celiac disease,taking small bowel biopsy as a gold standard

Objective: to determine the diagnostic accuracy of anti-tissue transglutaminase iga (anti-ttg iga) in the diagnosis of celiac disease,taking small bowel biopsy as a gold standard. study design: cross sectional study. setting: department of pediatric gastroenterology,the children's hospital and the institute of child health,multan,university of health sciences,lahore,pakistan. duration: july 2011 to march 2012. subjects & methods: children presenting in pediatric gastroenterology outpatient department with suspicion of celiac disease were recruited. selected patients were admitted in the ward to take duodenal biopsy and blood sample for anti-ttg iga level. in prepared patients,duodenal biopsy was taken under general anesthesia. at the same time,blood sample of the same patient was taken to determine anti-ttg iga level. the results were recorded on a proforma for analysis. results: among 117 children,60 were male (51.3%) and 57 female (48.7%).majority of children 96 (82.1%) were between 1–7 years of age. mean age was 5.1±2.7 years. most frequent presenting complaint was chronic diarrhea found in 101 (86.3%) children. among 117 suspected celiac patients,hist pathology was suggestive of celiac disease in 71 (60.7%) and in remaining 46 children biopsy was negative (39.3%).antittg iga levels were positive (>1 7 u/ml) in 88 children (75.2%) & negative in 29 (24.8%). conclusion: human iga-anti-ttg is a promising screening test for the celiac disease having high sensitivity but low specificity. so it can lead to the over diagnosis. © 2015,pakistan pediatric journal. all rights reserved.