Muhammad Waqar Rabbani, Muhammad Tariq Aziz, Abdul Basit, Imran Iqbal.
Diagnostic Accuracy of Serum Anti-Tissue Transglutaminase IgA, in the Diagnosis of Celiac Disease, Taking Small Bowel Biopsy as a Gold Standard.
Pak Paed J Jan ;39(4):203-8.

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, histopathology 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.

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