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Transglutaminase antibodies in children with a genetic risk for celiac disease

E J Hoffenberg1, F Bao, G S Eisenbarth

  • 1Section of Pediatric Gastroenterology, Hepatology, and Nutrition, Center for Pediatric Inflammatory Bowel Diseases, Department of Pediatrics, Barbara Davis Center for Childhood Diabetes, Denver, Colorado, USA.

The Journal of Pediatrics
|September 2, 2000
PubMed

Insights

The transglutaminase (TG) antibody test accurately predicts celiac disease in asymptomatic children with genetic risk. This test identifies children with biopsy-confirmed celiac disease before symptoms manifest.

Area of Science:

  • Pediatric Gastroenterology
  • Immunology
  • Genetics

Background:

  • Celiac disease diagnosis in children typically relies on symptomatic presentation.
  • Transglutaminase (TG) antibody testing is a sensitive marker for celiac disease.

Purpose of the Study:

  • To evaluate the positive predictive value of TG antibody testing in asymptomatic children at genetic risk for celiac disease.
  • To explore the correlation between TG antibody titers, small bowel histology, and clinical features in this population.

Main Methods:

  • Asymptomatic children with a known genetic predisposition for celiac disease were enrolled.
  • Small bowel biopsies were performed and histologically graded using the Marsh classification.
  • TG antibody levels were measured and correlated with biopsy findings, growth parameters, and clinical presentation.

Main Results:

  • Among 30 children with positive TG antibody tests, 70% showed definite (Marsh 2 or 3) and 13% showed possible (Marsh 1) biopsy evidence of celiac disease.
  • A significant positive correlation was observed between TG antibody titer and Marsh score (r = 0.569, P <.01).
  • An inverse correlation was found between Marsh score and height z score (r = -0.361, P =.05).

Conclusions:

  • TG antibodies demonstrate a positive predictive value of 70%–83% for biopsy-confirmed celiac disease in asymptomatic, genetically at-risk children.
  • TG antibody testing can identify children with celiac disease prior to the development of overt clinical symptoms.
  • This suggests TG antibody screening is valuable for early detection in at-risk pediatric populations.
Abstract

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